Excessive-Dose Fish Oil Could Increase Odds for A-Fib in Coronary heart Sufferers

MONDAY, Could 3, 2021 (HealthDay Information) — Many individuals take fish oil to guard their coronary heart, however a brand new research means that prescription variations could elevate the chance of a typical coronary heart rhythm dysfunction.

At situation are prescription-strength omega-3 fatty acids, that are naturally present in fish oil. The drugs are sometimes prescribed to folks with very excessive triglycerides, a kind of blood fats linked to elevated danger of coronary heart assault and stroke.

In response to the American Coronary heart Affiliation, prescription omega-3s can decrease triglycerides by 20% to 30% in most individuals.

However the drugs are additionally controversial, as a result of their final advantages for the center are unclear.

Now the brand new research — an evaluation of 5 previous medical trials — suggests warning is so as. Total, trial sufferers given omega-3s have been over one-third extra prone to develop atrial fibrillation (a-fib) than these given a placebo. The fish oil doses taken ranged from 0.84 grams to 4 grams per day.

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A-fib is a typical coronary heart rhythm dysfunction, or arrhythmia, wherein the center’s higher chambers start to quiver chaotically as an alternative of contracting successfully.

A-fib just isn’t instantly life-threatening, however it’s “not benign,” both, mentioned Dave Dixon, one of many researchers on the research and an affiliate professor at Virginia Commonwealth College (VCU), in Richmond.

Over time, Dixon mentioned, a-fib can result in problems like coronary heart failure or stroke.

Precisely how prescription-strength omega-3 may contribute to a-fib is unclear, in response to Dixon.

Nonetheless, the elevated danger was pretty constant throughout the trials — extra constant, actually, than coronary heart advantages have been, mentioned co-researcher Salvatore Carbone, an assistant professor at VCU.

In all 5 trials, there have been extra a-fib instances amongst omega-3 sufferers than placebo sufferers, although the distinction in danger was not statistically important in all research.

However when the researchers pooled the outcomes of all 5 trials, there was a transparent outcome: Omega-3 sufferers have been 37% extra prone to develop a-fib than placebo sufferers have been.

In distinction, just one trial confirmed that an omega-3 product may reduce the dangers of different coronary heart situations.

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In that trial, dubbed REDUCE-IT, sufferers utilizing a product referred to as Vascepa (icosapent ethyl) noticed their danger of “cardiovascular occasions” drop by 25%. That included coronary heart assault, stroke and loss of life from cardiovascular causes.

Even in that research, although, a-fib danger rose amongst omega-3 customers, by 35%.

Why has just one trial discovered coronary heart advantages? Once more, it is not but clear, Dixon mentioned.

However, he added, Vascepa is completely different from the fish oil merchandise examined within the different trials. It accommodates just one omega-3, referred to as EPA, whereas the opposite merchandise comprise a mix of EPA and DHA.

And within the REDUCE-IT trial, Dixon mentioned, greater ranges of EPA in sufferers’ blood correlated to decrease cardiovascular dangers.

That hints, he mentioned, that specializing in EPA could be “the way in which to go sooner or later.” However the conflicting findings on the advantages of omega-3s — together with the potential danger of a-fib — spotlight the necessity for extra research, the researchers mentioned.

The evaluation was printed April 29 within the European Coronary heart Journal — Cardiovascular Pharmacotherapy.

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Findings on the center advantages of fish oil have certainly been “inconsistent,” mentioned Linda Van Horn, a member of the center affiliation’s diet committee and a professor at Northwestern College Feinberg Faculty of Drugs, in Chicago.

And that features low-dose, over-the-counter fish oil dietary supplements.

“There are restricted and inconsistent knowledge concerning the profit or danger of taking fish oil dietary supplements,” Van Horn mentioned.

So the center affiliation recommends consuming two servings of fish every week as an alternative. Van Horn mentioned that fatty fish, comparable to salmon, trout, albacore tuna and herring, are one of the best sources of omega-3s.

The trials within the present evaluation examined prescription-strength omega-3s. However Carbone mentioned he could be cautious about over-the-counter fish oil dietary supplements, too.

“We do not know if over-the-counter merchandise may have these identical results,” he mentioned.

Over-the-counter fish oil is taken into account a dietary complement, so it’s not regulated by the U.S. Meals and Drug Administration as a drug could be, Dixon identified.

Each he and Carbone mentioned it is best to speak to a physician or pharmacist earlier than beginning any fish oil product — and that individuals on prescription omega-3s ought to communicate with their physician earlier than stopping.

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Extra data

Harvard Medical Faculty has extra on fish oil and coronary heart well being.

SOURCES: Salvatore Carbone, PhD, assistant professor, kinesiology and well being sciences, Virginia Commonwealth College, Richmond, Va.; Dave L. Dixon, PharmD, affiliate professor, ambulatory care, and vice-chair, medical providers, division of pharmacotherapy and outcomes science, Virginia Commonwealth College, Richmond, Va.; Linda Van Horn, PhD, RD, professor and chief, diet division, division of preventive medication, Northwestern College Feinberg Faculty of Drugs, Chicago, and member, Vitamin Committee, American Coronary heart Affiliation, Dallas; European Coronary heart Journal—Cardiovascular Pharmacotherapy, April 29, 2021, on-line