In a recent study published in BMJ Medicine, Researchers examined the consequences of fish oil complement use on the clinical progression of heart problems (CVD) in a prospective cohort of UK Biobank participants.
They found that regular use of fish oil supplements was related to an increased risk of atrial fibrillation (AF) and stroke in healthy people, but showed advantages in reducing serious antagonistic cardiovascular events and death in individuals with existing heart problems.
Test: Regular use of fish oil supplements and the course of heart problems: a prospective cohort study. Photo credit: Galina Zhigalova/Shutterstock.com
Background
Heart problems is the leading reason behind death worldwide, accounting for around one sixth of all deaths within the UK. Fish oil wealthy in omega-3 fatty acids is advisable for the prevention of heart problems, in step with British guidelines recommending eating a minimum of one serving of oily fish per week.
Nonetheless, the consequences of fish oil are controversial. Some studies suggest advantages of fish oil for ischemic stroke, but not for AF and major cardiovascular events.
Then again, the REDUCE-IT trial (short for Reduction of Cardiovascular Events with Icosapent Ethyl Interventional Trial) showed a discount in cardiovascular events with icosapent ethyl in patients with high triglyceride levels.
Previous studies examining the association between fish oil consumption and heart problems have mainly focused on single health outcomes or specific stages of heart problems, and none have focused on the progression of heart problems.
This highlights the necessity for further research into the various effects of fish oil. To fill this gap, researchers in the current study examined the consequences of fish oil complement use on cardiovascular outcomes and disease progression in individuals with and without established heart problems.
In regards to the study
This study involved 415,737 participants from the UK Biobank. The common age of participants was 55.9 years and 55% were women. Patients with missing or abnormal data and patients with AF, heart failure, myocardium, stroke, or cancer at baseline were excluded.
Regular use of fish oil supplements was self-reported via a questionnaire at baseline, and participants were divided into using and non-using categories. Data were collected on covariates, including demographic aspects, dietary information, lifestyle, comorbidities similar to diabetes and hypertension, and medications.
Participants were followed until death or study end date or were lost to follow-up, with a median follow-up of 11.9 years. Incident cases were identified from records in various registers. Statistical evaluation consisted of using the Student’s chi-square test T-test, multistate regression models, likelihood ratio test, hazard ratio (HR) and sensitivity analyses.
Results and discussion
About 31.4% of those surveyed usually consumed fish oil supplements. Compared with non-supplement users, regular use of fish oil supplements was found to be more common in older people, Caucasians and ladies, in addition to in individuals who consumed higher amounts of alcohol and in individuals who consumed oily and non-oily fish.
Through the study period, 18,367 participants developed AF (Transition A), 17,826 had major antagonistic cardiovascular events (Transition B), and 14,902 participants died without either (Transition C). Amongst those with incident AF, 4,810 had major antagonistic cardiovascular events (Transition D) and 1,653 died (Transition E).
Regular consumption of fish oil was found to be related to an increased risk of AF (HR = 1.13), but had no significant effect on major antagonistic cardiovascular events or death. In patients with AF, it reduced the chance of major antagonistic cardiovascular events and barely protected against death.
Even though it barely increased the chance of stroke (HR: 1.05), it lowered the chance of heart failure (HR: 0.92). In patients with AF, it reduced the chance of myocardial infarction, and in patients with heart failure, it reduced the chance of mortality.
Stratified evaluation showed that gender, age, consumption of non-oily fish, smoking, hypertension, and the usage of antihypertensive drugs and statins influenced the association between regular fish oil consumption and the occurrence of AF.
Furthermore, the association between fish oil consumption and the occurrence of great antagonistic cardiovascular events was found to be stronger in women and non-smokers.
Interestingly, the protective effects of fish oil against death were more significant in men and older participants. The outcomes of the sensitivity evaluation confirmed the foremost findings.
The study is strengthened by its large sample size, long follow-up period, complete health outcomes data, and use of a multistate design.
Nonetheless, the study is restricted by its observational design, potential residual confounding, lack of information on fish oil dose and composition, possible underestimation of AF events, limited generalizability, and unaccounted for behavioral changes in line with different cardiovascular profiles.
Application
Taken together, the findings suggest that regular consumption of fish oil supplements may potentially increase the chance of AF and stroke in healthy people.
Nonetheless, in individuals with existing heart problems, regular consumption of fish oil supplements could also be useful in stopping the progression of AF to serious antagonistic cardiovascular events and death.
The findings highlight the necessity to develop tailored recommendations for the usage of these supplements and warrant further research to know the underlying mechanisms, ultimately leading to higher clinical guidelines and patient care.