Old Fish Wives Tails – not any more
Evidence is building that high quality fish oils containing high levels of EPA and DHA are proving very useful to Heart Failure patients
“Adding n-3 polyunsaturated fatty acids, even in patients that had a major improvement [on standard treatment], showed a further improvement in heart function and exercise capacity,” said study co-author Dr. Mihai Gheorghiade, a professor of cardiology at Northwestern University‘s Feinberg School of Medicine.
This shows that even in patients who respond to therapy, “we can make them much better,” he added. “This opens the door for the potential of a natural therapy — so-called macronutrients — in the management of heart failure.”
Gheorghiade cautioned that this study is not conclusive, but nutrients such as omega-3 fatty acids might extend life and quality of life for these patients.
The report is published in the Jan. 5 online edition of the Journal of the American College of Cardiology.
Gheorghiade’s team randomly assigned 133 heart failure patients with minimal symptoms on standard therapy, which included beta blockers, to high doses (2 grams) of omega-3 fatty acid supplements or a placebo.
After a year, those receiving the omega-3 supplement showed a 10.4 percent increase in heart function, compared with a 5 percent decrease among those taking placebo, the researchers found.
In addition, blood oxygen levels increased 6.2 percent in the omega-3 patients and decreased 4.5 percent in the placebo patients. Also, exercise time went up 7.5 percent in those receiving supplements while it went down 4.8 percent in those receiving placebo, they added.
Moreover, among those taking the supplement the hospitalisation rate was 6 percent during the year, compared with 30 percent for those on placebo.
Gheorghiade speculated that the supplements improved the metabolism of the heart. “This is one example where a nontraditional therapy may also work,” he said.
However, larger studies are needed to really see if this supplement helps prolong life, Gheorghiade said. “It’s promising, but it’s not conclusive,” he said. “But it would be a mistake not to look at the value of the macro and micronutrients in the management of heart failure.”
Gheorghiade doesn’t recommend that people take large amounts of this supplement in hopes of staving off heart disease. Whether or not one should take a supplement is a topic that patients and their doctors should discuss, he said.
Treatment needs to be tailored to individual patients, he pointed out. “This is not a cookbook,” Gheorghiade added.
Dr. W.H. Wilson Tang, an assistant professor of medicine at the Cleveland Clinic and co-author of an accompanying journal editorial, said that “studies on omega-3 fatty acid in heart failure still have not been effectively tested, based on limitations on their designs.”
Tang added, “We need to know what are potential dose and timing of intervention before we can effectively demonstrate whether an intervention works or not.”
The current study suggested that doses far higher than commonly used may have some effect not seen in the larger studies, he said.
“That being said, whether every treatment approach needs mega-trials to demonstrate effectiveness is now being increasingly challenged. The current debate is whether a relatively safe intervention such as fish oil should be recommended based on the current data — it is currently written in some guidelines but not too many doctors are actively recommending them,” Tang said.
Douglas “Duffy” MacKay, vice president for scientific and regulatory affairs at the Council for Responsible Nutrition, which represents the supplement industry, said that “all adults should get 500 milligrams of omega-3 fatty acids, from either diet or supplements, just to maintain heart health.”
The American Heart Association also recommends that people get omega-3 fatty acids for heart health, with at least two servings a week of fatty fish, such as tuna, sardines or salmon, mackerel, herring or lake trout.