Healthy living: November 13, 2018

BANGOR, Maine (WABI) – Last Saturday at a conference of the American Heart Association in Chicago, researchers announced the results of two major studies to determine who benefits and who might not benefit from the supplements commonly used to reduce risk cardiovascular. First, the bad news: fish oil and vitamin D taken by healthy people at doses found in many over-the-counter supplements have apparently shown no net benefit to health. However, the good news is that for people at higher risk because of high triglyceride levels, the use of prescription medications may be associated with a lower risk of heart attack and stroke, although that's at a cost.

Specifically, the first study compared the use of the drug Vascepa to that of a mineral oil-based placebo for 8,000 patients over a 5-year interval. Their findings, as reported by the New England Journal of Medicine and the Associated Press, demonstrated a decreased risk of death and stroke. The data analysis of the NNT (how many patients are "necessary to treat") has shown that only 21 people should take the drug for five years to benefit from one of these benefits, which is favorable compared to other NNT statistics for many medical interventions The average monthly cost of $ 280 for this drug is of concern to many people who may not have insurance. A five-year expense for this drug would be around $ 17,000.

The second study involved an older drug, marketed as Lovaza or Omacor, and showed less dramatic benefits with fewer heart attacks, but experts were divided on the implications. Since the placebo group received olive oil instead of the mineral oil used in the Vascepa study, the benefit may not have been not been so obvious. This second study also examined vitamin D, with participants taking 2,000 units against dummy pills for five years. Unfortunately, vitamin D had no additional beneficial effect on the risks of heart disease or stroke, but there was a very slight decrease in the number of cancer deaths. Because cancer can take years to develop, the authors of the study advocated a longer study to define this possible benefit. However, other experts, such as Clifford Rosen, former Bangor physician and currently working for the Maine Medical Center, have recommended that these effects of vitamin D be interpreted with caution.
So, what is the net result for the average informed health care consumer? If you have the definite diagnosis of high triglycerides, it would be wise to have the conversation with your personal physician on how to fix this problem. Certainly, if you could treat this with the standard diet containing less carbohydrates, initially advised for most patients, this would not only be cheaper, but probably safer in the long run. However, if this preventive intervention is not effective for you, you may be a candidate for this class of drugs. For the rest of us, you might want to save the money you spent for the high dose of vitamin D or fish oil and better use it – as these fishing vacation in the Gulf of Mexico. You will probably get a lot of vitamin D in the sun (do not forget your block!), But with a little luck, you can enjoy tasty fish dinners and have only beneficial oils!