Treat high triglyceride levels with Omega-3 fatty acids

Washington: Omega-3 fatty acid medication reduces triglyceride levels by 20-30 per cent among the majority of people who require treatment for high triglyceride levels, suggests a study. The study was published in the journal 'Circulation.'

"From our review of the evidence from 17 randomised, controlled clinical trials on high triglyceride levels, we concluded that treatment with 4 grams daily of any of the available prescription choices are effective and can be used safely in conjunction with statin medicines that lower cholesterol," said Ann Skulas-Ray, an author of the study.

There are two prescription omega-3 fatty acid medications available. One combines two types of fatty acids, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). The other medication provides EPA only. Since there have been no head-to-head comparisons of the two different formulations at prescription dosing, the advisory does not recommend one over the other.

Triglycerides are fats that circulate in the blood. Some studies have shown that elevated levels of triglycerides (above 200 mg/dL) can lead to atherosclerosis (narrowing of the arteries), which increases the risk of heart attack and stroke. In addition to cardiovascular risk, very high levels of triglycerides (above 500 mg/dL) can also cause pancreatitis, an inflammation of the pancreas.

Skulas-Ray pointed out that people with high triglyceride levels should not try to treat the condition themselves with non-prescription, omega-3 fatty acid fish oil supplements. "Dietary supplements containing omega-3 fatty acids are not regulated by the FDA. They should not be used in place of prescription medication for the long-term management of high triglycerides," said Skulas-Ray.

The effective dose for prescription omega-3 fatty acids is four grams per day taken with food. Currently, the FDA has approved prescription omega-3 fatty acid medications only for treating very high triglyceride levels above 500 mg/dL.

Fish is a good source of omega-3 fatty acids, and the American Heart Association recommends eating fatty fish - such as salmon, mackerel, herring and albacore tuna - at least two times per week. In the analysis of the current scientific data, the advisory panel found that most people with high triglycerides (200 to 499 mg/dL), prescription doses of omega-3 fatty acids using drugs with either EPA+DHA or EPA alone can reduce triglyceride by 20 to 30 per cent.

Contrary to common perception, the formula that contains both EPA and DHA does not increase the "bad" form of cholesterol (LDL-C) among most people with high triglyceride levels (200-499 mg/dL). However, when the drug is given to people with very high triglyceride levels at 500 mg/dL or greater, LDL-C may increase. The panel's review found that prescription omega-3 drugs are effective in reducing triglyceride levels regardless of whether people are on statin therapy.

In a recent large, randomized placebo-controlled study called REDUCE-IT, researchers found that the EPA-only medication combined with statin medication resulted in a 25 per cent reduction in major cardiovascular events (heart attack, stroke and cardiovascular death) among people with high triglycerides.