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No cardiovascular benefit from fish oil for high risk adults

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f3086 (Published 15 May 2013) Cite this as: BMJ 2013;346:f3086

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Fish oils did nothing for Italian adults with multiple cardiovascular risk factors in a recent trial. Those who took the 1 g capsules every day for a median of five years were no less likely to die or be admitted to hospital with cardiovascular disease than controls who took an equal measure of olive oil instead (11.7% (733/6239) v 11.9% (745/6266); adjusted hazard ratio 0.97, 95% CI 0.88 to 1.08). The results were a disappointment because fish oils do benefit people with myocardial infarction or heart failure, say the authors, mostly by reducing the risk of sudden cardiac death.

Participants in the latest trial had no history of myocardial infarction and very few had heart failure, but they did have hypertension, hypercholesterolaemia, diabetes, obesity, other risk factors, or clinical evidence of atherosclerosis. The two groups had almost identical cardiovascular outcomes over five years. Secondary analyses hinted at possible benefits for women and a reduction in admissions for heart failure associated with fish oil, but the authors warn that both results should be treated with caution.

For now, we must assume that extra fish oil doesn’t help prevent cardiovascular death or disease in high risk adults without myocardial infarction, they write—at least not in Italy. About three quarters of these participants regularly ate oily fish.

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Cite this as: BMJ 2013;346:f3086