Fish Oil (Omega 3 fatty acids has been touted as a having heart and vascular protective effects for many years. In 2018, a number of large clinical studies including studies in people with diabetes showed that fish oil had little to no effect in reducing cardiovascular events. This was quite disappointing to doctors and patients alike and many stopped taking fish oil.
- Then in 1/19 a large study called the Reduce-It Trial was published in the New England Journal of Medicine. It looked at the effect of an Omega 3 fatty which was a specific component of fish oil—EPA or icosapent ethyl in people with known heart disease and/or diabetes. Let me tell you a bit about the people enrolled in the study. The study included people who were 45 years of age or older with known heart disease OR who were 50 years of age or older and diabetes mellitus and at least 1 additional heart risk factor.
- They had to have a fasting triglyceride of 150-499 mg/dl and their cholesterol had to be already well controlled on a statin. The LDL cholesterol at the start of the study was really very controlled and was in the mid 70’s.
- The study went on for 5 years. The remarkable finding was that the icosapent ethyl reduced cardiovascular death, heart attack and stroke considerably. This was phenomenal news to those of us who every day, treat people with heart disease and heart disease risk.
In summary, in the past year, we learned that regular fish oil doesn’t have the heart disease reduction effect that was claimed but that a specific derivation of fish oil, the omega 3 fatty acid icosapent ethyl (only available by prescription) reduces cardiovascular death and heart attacks and strokes in the people described above.
We at Texas Diabetes and Endocrinology continually strive to be current and at the forefront of using interventions to reduce heart attack and stroke risk. We are experts in diabetes and heart risk factor management. One of our doctors and one of our clinical nurse specialists, Ashley Davila CNS, are boarded in Lipidology. We are also members of the National Lipid Association. We perform noninvasive heart disease risk assessments with an easy ultrasound based arterial assessment called Carotid Intimal Medial Thickness (CIMT). We also obtain “advanced lipid tests” in many individuals to help in their cardiovascular risk reduction/prevention.
We have participated in many clinical research studies evaluating a number of medications used to lower cholesterol. We are soon enrolling a study to evaluate the effect of a medication on lowering Lp(a) also called lipoprotein little a, which is an important indicator of heart attack and stroke risk. If you or any of your family has been told that you have an elevated Lp(a), please call our office and ask for the research department.