From the Guidelines
Supplementing with fish oil has not been demonstrated to have cardiovascular outcomes benefits for the general population, and its use is not recommended for ASCVD risk reduction without a specific clinical indication, such as severe hypertriglyceridemia or established cardiovascular disease, as supported by the most recent evidence 1. When considering the use of fish oil supplements for cardiovascular health, it's essential to differentiate between nonprescription fish oil products and prescription omega-3 fatty acid products. Nonprescription fish oil products are not regulated by the FDA to the same extent as prescription medications and may contain impurities or varying levels of active ingredients, which can lead to inconsistent efficacy and potential side effects 1. For individuals with severe hypertriglyceridemia (triglycerides ≥500 mg/dL) or established cardiovascular disease, prescription omega-3 fatty acid products, such as icosapent ethyl (IPE), have been shown to reduce triglyceride levels and cardiovascular risk when used as an adjunct to maximally tolerated statin therapy 1. The benefits of fish oil supplementation appear to be most significant for those with existing cardiovascular risk factors, such as high triglycerides or established heart disease, rather than healthy individuals 1. Common side effects of fish oil supplements include fishy aftertaste, mild digestive issues, and potential interactions with blood thinners, highlighting the need for careful consideration and consultation with a healthcare provider before initiating supplementation 1. In the context of real-life clinical practice, prioritizing evidence-based recommendations that focus on morbidity, mortality, and quality of life outcomes is crucial, and the use of fish oil supplements should be guided by the most recent and highest-quality evidence available 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Cardiovascular Benefits of Fish Oil Supplementation
The potential cardiovascular benefits of supplementing with fish oil have been extensively studied. Some of the key benefits include:
- Reduction in high triglycerides: Fish oil, in clinically used doses, has been shown to reduce high triglycerides 2, 3, 4.
- Lowering of blood pressure: Fish oil supplementation has been found to have a beneficial effect on blood pressure, with one study showing a decrease in systolic blood pressure in patients treated for coronary artery disease 4.
- Prevention of atrial fibrillation: Fish oil may help prevent atrial fibrillation, a type of irregular heartbeat 3.
- Reduction in mortality rates: Some studies have suggested that fish oil supplementation may reduce mortality rates in patients with congestive heart failure 3, 5.
- Stabilization of atherosclerotic plaques: Fish oil may help stabilize atherosclerotic plaques, which can reduce the risk of heart attack and stroke 3, 6.
Mechanisms of Action
The mechanisms by which fish oil exerts its cardiovascular benefits are not fully understood, but may include:
- Anti-inflammatory effects: Fish oil has been shown to have anti-inflammatory properties, which may help reduce inflammation in the cardiovascular system 2, 6.
- Anti-oxidation effects: Fish oil may also have anti-oxidation effects, which can help protect against cell damage and reduce the risk of cardiovascular disease 6.
- Improvement in left ventricular remodeling: Fish oil may help improve left ventricular remodeling, which can reduce the risk of heart failure 6.
- Regulation of blood lipid levels: Fish oil may help regulate blood lipid levels, including reducing triglycerides and improving HDL and LDL cholesterol levels 2, 3, 4.
Current Evidence and Recommendations
The current evidence suggests that fish oil supplementation may have cardiovascular benefits, including reducing the risk of cardiovascular events and death 3, 6, 5. However, more research is needed to fully understand the effects of fish oil on cardiovascular health. Some studies have yielded inconsistent results, and the optimal dose and duration of fish oil supplementation are not yet established 2, 6.