Fish Helps Statins Protect the Heart
03.30.07, 12:00 AM ET

FRIDAY, March 30 (HealthDay News) -- People taking cholesterol-lowering drugs called statins who also consume omega-3 fatty acids -- typically found in fish and fish oil -- have a better chance of avoiding heart problems than patients who take statins alone.

That's the conclusion of a new study by Japanese researchers that is published in the March 31 issue of The Lancet.

"Our study shows that long-term use of EPA (an omega-3 fatty acid) at therapeutic doses is effective for prevention of major coronary events in hypercholesterolemia (high cholesterol) patients given statins in Japan who consume a large amount of fish," said lead researcher Dr. Mitsuhiro Yokoyama. He is a professor of medicine at the Kobe University Graduate School of Medicine.

In the study, called the Japan EPA Lipid Intervention Study, Yokoyama and his colleagues assigned 18,645 people to receive either 1,800 milligrams of one of the omega-3 fatty acids, eicosapentaenoic acid (EPA), every day plus a statin, or a statin alone.

During an average follow-up of 4.6 years, the researchers found a 19 percent reduction in major coronary events among patients taking EPA. Patients taking EPA also had 19 percent fewer non-fatal events -- including non-fatal heart attack, unstable angina, and coronary revascularization -- than people taking statins alone. However, the incidence of sudden cardiac death and death from heart disease did not differ between the groups.

The preventive effects of EPA are of both clinical interest and therapeutic importance, Yokoyama said. "EPA is thought to exert its plaque-stabilization effect via mechanisms that are independent of a reduction in cholesterol," he added.

Sickness and death from coronary artery disease is very low in Japan in comparison with the United States and northern Europe, Yokoyama said. "This difference might be explained partly due to differences in dietary habits, including fish consumption. We want to know whether our results can be generalized to other populations who consume a small intake of fish and have very high mortality from coronary artery disease," he said.

One expert thinks the study results aren't surprising, but they are interesting, because the research was done in a country where people eat more fish than they do in the United States.

"This study is further evidence of the benefit of omega-3 fatty acids for protecting against heart attacks and other cardiac events," said Dr. Dariush Mozaffarian, an assistant professor of epidemiology at Harvard Medical School and Harvard School of Public Health, and author of an accompanying editorial in the journal.

Mozaffarian said that the trial was done, in part, to see if combining EPA with a statin could be effective in reducing cardiac events.

While there did appear to be a benefit in taking EPA, coupling it with a statin in one pill isn't necessary, Mozaffarian said. "The pharmaceutical manufacturers are facing the end of patents on their statins," he said. "The idea of putting a statin and EPA in a single pill is really just marketing," he added.

Mozaffarian noted that a healthful diet should provide enough EPA to reduce the risk of heart trouble. "People should be able to get a cardioprotective dose of omega-3 fatty acids by eating fish twice a week," he said.