Fish Oil Supplements and Your Heart

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Advice from the American Heart Association

If you have heart failure or have recently had a heart attack, omega-3 fish oil supplements could be a beneficial addition to your medicine cabinet. Taking these supplements might slightly reduce your risk of dying of heart disease, according to a March 2017 scientific advisory from the American Heart Association (AHA) published in Circulation. Supplementing with omega-3s might also help to modestly lower the chances of hospitalization if you have heart failure.

Note, however, that there’s no evidence that omega-3 supplements can prevent a heart attack, stroke, or heart failure in people who don’t have cardiovascular disease. The AHA found no specific data to support taking supplements for the primary prevention of heart disease. Furthermore, it does not recommend that people who have type 2 diabetes, prediabetes, or atrial fibrillation, or who are at high risk of cardiovascular disease, take the supplements to prevent heart disease or stroke. The AHA arrived at these recommendations, it notes, due to lack of evidence or consensus.

A 2002 AHA scientific statement recommended that people with coronary heart disease get at least 1 g (1,000 mg) of omega-3 fatty acids daily, preferably from oily fish. Because many Americans don’t eat enough fish to get the omega-3s they need, the question has been whether it’s worth taking supplements to help prevent heart disease.

Studies on the subject have been conflicted. The new AHA statement aims to offer more specific guidance about omega-3 supplements based on randomized controlled trials-the most rigorous kind of scientific research available.

The omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are among the best-studied nutrients for cardiovascular health. Research has shown that omega- 3s from fish (not supplements) help relax artery walls, prevent blood clots, and bring down inflammation, thereby taking action against major contributors to heart disease and cardiovascular events like heart attacks. Because your body can’t make omega-3s, you need to get them from food sources-primarily from fatty fish such as salmon, mackerel, sardines, and tuna.

Who should take omega-3 supplements?

The AHA statement recommends considering them if you’ve had a recent heart attack, because they could reduce your risk of dying by about 10 percent. They’re also worth considering if you have heart failure with reduced ejection fraction-meaning your heart’s main pumping chamber can’t disperse enough oxygen-rich blood throughout your body.

The bottom line

The best way to protect your heart with omega-3s is by eating at least one to two servings of fatty fish weekly. Otherwise, if you don’t have coronary heart disease, supplements are likely not worth the cost.

If you have heart failure or have had a recent heart attack and you’re considering supplements, consult with your doctor, especially if you take a blood thinner, as omega-3s may increase its effect. Though omega-3 supplements are considered safe, they can have mild side effects, such as belching or diarrhea. You can buy the supplements over the counter, but the quality of nonprescription supplements varies widely. Ask your doctor if a prescription supplement, often used to help lower high triglyceride levels, may be warranted instead.