Omega-3 fatty acid prescribed medications effectively reduce high triglycerides

According to a scientific opinion of the American Heart Association, medications prescribed on the basis of omega-3 fatty acids reduce triglyceride levels by 20 to 30% in the majority of people in need of treatment for high rates of triglycerides.

"After reviewing the results of 17 randomized controlled clinical trials involving high triglyceride levels, we concluded that a treatment with 4 grams per day of one of the available prescription drugs is effective and can be used safely with cholesterol-lowering statin drugs, "said Ann Skulas-Ray, Ph.D., author of the new scientific opinion published in the journal of the American Heart Association circulation.

There are two prescription medications that contain omega-3 fatty acids. One combines two types of fatty acids, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). The other drug only provides EPA. As there was no head-to-head comparison of the two different formulations at the prescribed dosage, the opinion does not recommend one against the other.

Triglycerides are fats that circulate in the blood. Some studies have shown that high levels of triglycerides (greater than 200 mg / dL) can lead to atherosclerosis (narrowing of the arteries), which increases the risk of heart attack and stroke. In addition to cardiovascular risk, very high triglyceride levels (above 500 mg / dL) can also cause pancreatitis, an inflammation of the pancreas.

Skulas-Ray points out that people with high triglyceride levels should not try to treat the condition themselves with non-prescription and omega-3 fish oil supplements.

"Dietary supplements containing omega-3 fatty acids are not regulated by the FDA and should not be used in place of prescription drugs for the long-term management of high triglyceride levels," said Skulas-Ray. , assistant professor in the department. Nutrition Sciences at the University of Arizona at Tucson. In a 2017 scientific opinion, the American Heart Association noted the lack of scientific research supporting the clinical use of omega-3 fatty acid supplements to prevent heart disease in the general population .

The effective dose for omega-3 prescription is four grams a day, to be taken during a meal. At present, the FDA has approved prescription medications containing omega-3 fatty acids only to treat very high triglyceride levels above 500 mg / dL.

Healthy lifestyle choices, such as regular physical activity, losing weight, avoiding sugar and refined carbohydrates, limiting alcohol and choosing healthy fats from plants rather than saturated fats can help reduce triglycerides . It is also important to treat or eliminate conditions such as poorly controlled type 2 diabetes, hypothyroidism and obesity that can contribute to high triglyceride levels before taking a medication.

Fish is a good source of omega-3 fatty acids, and the American Heart Association recommends eating fatty fish, such as salmon, mackerel, herring and albacore, at least twice a week.

In analyzing the current scientific data, the Advisory Committee found:

• For most people with high triglyceride levels (200 to 499 mg / dL), prescribed doses of omega-3 fatty acids using drugs containing either EPA + DHA or EPA only can reduce triglycerides by 20 to 30%.
• Contrary to popular belief, the formula containing both EPA and DHA does not increase the "bad" form of cholesterol (LDL-C) in most people with high triglyceride levels ( 200 to 499 mg / dL). However, when the drug is administered to people with very high triglyceride levels of 500 mg / dL or higher, the LDL-C level may increase.
• The panel's review revealed that prescription-based omega-3 medications effectively reduce triglyceride levels, whether people take statin therapy or not.
• In a recent and large randomized, placebo-controlled, placebo-controlled trial called REDUCE-IT, the researchers found that drug therapy with statin-only EPA resulted in a 25% reduction in major cardiovascular events (heart attack, stroke and cardiovascular death) in triglycerides.

Elevated triglycerides are relatively common in the United States, and the prevalence is increasing because of rising rates of obesity and diabetes. Both conditions increase triglyceride levels. In the United States, approximately 25% of adults have a triglyceride level above 150 mg / dL, which is considered to be very high.