Omega-3 Fatty Acids: How Can They Be Used in Secondary Prevention?

Omega-3 fatty acids (FAs) are divided into long-chain fatty acids (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]), which are found in fatty fish, and intermediate-chain FAs (alpha-linolenic acid), which are found in vegetable oils. Omega-3 FAs favorably modulate a variety of vascular risk factors and also exert antiarrhythmic effects. Epidemiologic data suggest that increased consumption of marine omega-3 FAs is associated with reduced coronary heart disease (CHD) mortality. Randomized controlled studies also show that supplementation with EPA and DHA reduces CHD risk, primarily in the secondary prevention setting. Data are more limited on the efficacy of marine omega-3 FAs for the primary prevention of CHD and on the role of alpha-linolenic acid. Increased intake of EPA and DHA represents a valuable tool for vascular disease prevention and should be recommended in all patients with CHD.