From the Guidelines
Omega-3 fatty acids may have a potential role in mitigating cardiovascular risks, but the current evidence does not definitively support their use in reducing the risk of myocardial infarction and cerebrovascular accident associated with cannabis use. The most recent and highest quality study, REDUCE-IT 1, demonstrated a 25% reduction in the primary composite endpoint of cardiovascular death, nonfatal MI, nonfatal stroke, coronary revascularization, or unstable angina with 4g of EPA daily, but this study did not specifically examine cannabis users.
Key Findings
- The REDUCE-IT study 1 showed a significant reduction in cardiovascular events with high-dose EPA supplementation, but its applicability to cannabis users is unclear.
- Other studies, such as ASCEND 1 and VITAL 1, failed to show a significant reduction in cardiovascular endpoints with low-dose omega-3 supplementation.
- The OMEMI trial 2 found no significant difference in the primary endpoint of nonfatal MI, unscheduled revascularization, stroke, all-cause death, and heart failure hospitalization between omega-3 and placebo groups.
Mechanisms and Potential Benefits
- Omega-3 fatty acids may work by reducing inflammation, improving endothelial function, and decreasing platelet aggregation, which could counteract some of cannabis's negative cardiovascular effects.
- However, the potential protective effect of omega-3s against cannabis-related cardiovascular risks is theoretical and not definitively proven in clinical studies.
Recommendations
- If you use cannabis and are concerned about cardiovascular health, incorporating omega-3 supplements (typically 1-3 grams daily of combined EPA and DHA) or consuming fatty fish like salmon, mackerel, or sardines 2-3 times weekly may provide some cardiovascular benefits.
- The most effective way to reduce cannabis-related cardiovascular risk remains moderation or cessation of cannabis use, particularly for those with existing heart conditions.
- If you use cannabis medicinally, discuss with your healthcare provider about balancing benefits against cardiovascular risks.
From the Research
Omega-3 Fatty Acids and Cardiovascular Health
- Omega-3 fatty acids, particularly EPA and DHA, have been associated with reduced risk of cardiovascular disease, including myocardial infarction and stroke 3, 4, 5, 6, 7.
- The mechanisms by which omega-3 fatty acids exert their effects on cardiovascular health include reducing inflammation, improving lipid profiles, and preventing platelet aggregation 4, 5, 6.
Omega-3 Fatty Acids and Stroke Risk
- Higher levels of EPA have been correlated with a lower prevalence of ischemic brain infarcts in patients with atrial fibrillation 3.
- DHA and DPA have been associated with a lower risk of incident ischemic stroke, with DHA showing a stronger association with atherothrombotic stroke and DPA with cardioembolic stroke 7.
Omega-3 Fatty Acids and Myocardial Infarction Risk
- While there is evidence to suggest that omega-3 fatty acids may reduce the risk of myocardial infarction, the relationship between omega-3 fatty acids and myocardial infarction risk is not as well-established as it is for stroke risk 4, 5, 6.
- However, omega-3 fatty acids have been shown to improve cardiovascular function and reduce the risk of major coronary events 4, 6.