Marine Omega‐3 Supplementation and Cardiovascular Disease: An Updated Meta‐Analysis of 13 Randomized Controlled Trials Involving 127 477 Participants
Background Whether marine omega‐3 supplementation is associated with reduction in risk of cardiovascular disease (CVD) remains controversial. Methods and Results This meta‐analysis included study‐level data from 13 trials. The outcomes of interest included myocardial infarction, coronary heart disea...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2019-10-01
|
| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.013543 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850125082160005120 |
|---|---|
| author | Yang Hu Frank B. Hu JoAnn E. Manson |
| author_facet | Yang Hu Frank B. Hu JoAnn E. Manson |
| author_sort | Yang Hu |
| collection | DOAJ |
| description | Background Whether marine omega‐3 supplementation is associated with reduction in risk of cardiovascular disease (CVD) remains controversial. Methods and Results This meta‐analysis included study‐level data from 13 trials. The outcomes of interest included myocardial infarction, coronary heart disease (CHD) death, total CHD, total stroke, CVD death, total CVD, and major vascular events. The unadjusted rate ratios were calculated using a fixed‐effect meta‐analysis. A meta‐regression was conducted to estimate the dose–response relationship between marine omega‐3 dosage and risk of each prespecified outcome. During a mean treatment duration of 5.0 years, 3838 myocardial infarctions, 3008 CHD deaths, 8435 total CHD events, 2683 strokes, 5017 CVD deaths, 15 759 total CVD events, and 16 478 major vascular events were documented. In the analysis excluding REDUCE‐IT (Reduction of Cardiovascular Events with Icosapent Ethyl‐Intervention Trial), marine omega‐3 supplementation was associated with significantly lower risk of myocardial infarction (rate ratio [RR] [95% CI]: 0.92 [0.86, 0.99]; P=0.020), CHD death (RR [95% CI]: 0.92 [0.86, 0.98]; P=0.014), total CHD (RR [95% CI]: 0.95 [0.91, 0.99]; P=0.008), CVD death (RR [95% CI]: 0.93 [0.88, 0.99]; P=0.013), and total CVD (RR [95% CI]: 0.97 [0.94, 0.99]; P=0.015). Inverse associations for all outcomes were strengthened after including REDUCE‐IT while introducing statistically significant heterogeneity. Statistically significant linear dose–response relationships were found for total CVD and major vascular events in the analyses with and without including REDUCE‐IT. Conclusions Marine omega‐3 supplementation lowers risk for myocardial infarction, CHD death, total CHD, CVD death, and total CVD, even after exclusion of REDUCE‐IT. Risk reductions appeared to be linearly related to marine omega‐3 dose. |
| format | Article |
| id | doaj-art-4fe2df5c4b01434d8887b849dc336868 |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2019-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-4fe2df5c4b01434d8887b849dc3368682025-08-20T02:34:10ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802019-10-0181910.1161/JAHA.119.013543Marine Omega‐3 Supplementation and Cardiovascular Disease: An Updated Meta‐Analysis of 13 Randomized Controlled Trials Involving 127 477 ParticipantsYang Hu0Frank B. Hu1JoAnn E. Manson2Department of Nutrition Harvard T.H. Chan School of Public Health Boston MADepartment of Nutrition Harvard T.H. Chan School of Public Health Boston MADepartment of Epidemiology Harvard T.H. Chan School of Public Health Boston MABackground Whether marine omega‐3 supplementation is associated with reduction in risk of cardiovascular disease (CVD) remains controversial. Methods and Results This meta‐analysis included study‐level data from 13 trials. The outcomes of interest included myocardial infarction, coronary heart disease (CHD) death, total CHD, total stroke, CVD death, total CVD, and major vascular events. The unadjusted rate ratios were calculated using a fixed‐effect meta‐analysis. A meta‐regression was conducted to estimate the dose–response relationship between marine omega‐3 dosage and risk of each prespecified outcome. During a mean treatment duration of 5.0 years, 3838 myocardial infarctions, 3008 CHD deaths, 8435 total CHD events, 2683 strokes, 5017 CVD deaths, 15 759 total CVD events, and 16 478 major vascular events were documented. In the analysis excluding REDUCE‐IT (Reduction of Cardiovascular Events with Icosapent Ethyl‐Intervention Trial), marine omega‐3 supplementation was associated with significantly lower risk of myocardial infarction (rate ratio [RR] [95% CI]: 0.92 [0.86, 0.99]; P=0.020), CHD death (RR [95% CI]: 0.92 [0.86, 0.98]; P=0.014), total CHD (RR [95% CI]: 0.95 [0.91, 0.99]; P=0.008), CVD death (RR [95% CI]: 0.93 [0.88, 0.99]; P=0.013), and total CVD (RR [95% CI]: 0.97 [0.94, 0.99]; P=0.015). Inverse associations for all outcomes were strengthened after including REDUCE‐IT while introducing statistically significant heterogeneity. Statistically significant linear dose–response relationships were found for total CVD and major vascular events in the analyses with and without including REDUCE‐IT. Conclusions Marine omega‐3 supplementation lowers risk for myocardial infarction, CHD death, total CHD, CVD death, and total CVD, even after exclusion of REDUCE‐IT. Risk reductions appeared to be linearly related to marine omega‐3 dose.https://www.ahajournals.org/doi/10.1161/JAHA.119.013543cardiovascular diseasesfish oilmarine omega‐3 supplementationmeta‐analysisrandomized controlled trials |
| spellingShingle | Yang Hu Frank B. Hu JoAnn E. Manson Marine Omega‐3 Supplementation and Cardiovascular Disease: An Updated Meta‐Analysis of 13 Randomized Controlled Trials Involving 127 477 Participants Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiovascular diseases fish oil marine omega‐3 supplementation meta‐analysis randomized controlled trials |
| title | Marine Omega‐3 Supplementation and Cardiovascular Disease: An Updated Meta‐Analysis of 13 Randomized Controlled Trials Involving 127 477 Participants |
| title_full | Marine Omega‐3 Supplementation and Cardiovascular Disease: An Updated Meta‐Analysis of 13 Randomized Controlled Trials Involving 127 477 Participants |
| title_fullStr | Marine Omega‐3 Supplementation and Cardiovascular Disease: An Updated Meta‐Analysis of 13 Randomized Controlled Trials Involving 127 477 Participants |
| title_full_unstemmed | Marine Omega‐3 Supplementation and Cardiovascular Disease: An Updated Meta‐Analysis of 13 Randomized Controlled Trials Involving 127 477 Participants |
| title_short | Marine Omega‐3 Supplementation and Cardiovascular Disease: An Updated Meta‐Analysis of 13 Randomized Controlled Trials Involving 127 477 Participants |
| title_sort | marine omega 3 supplementation and cardiovascular disease an updated meta analysis of 13 randomized controlled trials involving 127 477 participants |
| topic | cardiovascular diseases fish oil marine omega‐3 supplementation meta‐analysis randomized controlled trials |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.013543 |
| work_keys_str_mv | AT yanghu marineomega3supplementationandcardiovasculardiseaseanupdatedmetaanalysisof13randomizedcontrolledtrialsinvolving127477participants AT frankbhu marineomega3supplementationandcardiovasculardiseaseanupdatedmetaanalysisof13randomizedcontrolledtrialsinvolving127477participants AT joannemanson marineomega3supplementationandcardiovasculardiseaseanupdatedmetaanalysisof13randomizedcontrolledtrialsinvolving127477participants |