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Increased intakes of omega-3 fatty acids may not reduce cardiovascular disease risk in elderly AMD patients

March 20, 2014

According to a new data analysis, a regular supplementation with omega-3 fatty acids appears not to decrease the cardiovascular disease risk in elderly patients with age-related macular degeneration. People with no history of hypertension or cardiovascular disease may, however, benefit significantly.

To determine if supplementing a diet with long-chain omega-3 polyunsaturated fatty acids or with lutein and zeaxanthin results in a reduced rate of cardiovascular disease (CVD), the study analyzed data of AREDS2 involving 4,203 elderly patients (median age of 74 years) with age-related macular degeneration (AMD) who received, in addition to a defined (AREDS) vitamin and mineral formulation, daily supplements containing 650 mg eicosapentaenoic acid (EPA) plus 350 mg docosahexaenoic acids (DHA), 10 mg lutein and 2 mg zeaxanthin, the omega-3 fatty acids plus the carotenoids or a placebo for a median of 4.8 years (1). The analysis showed that, overall, no statistically significant reductions for CVD were observed for the partici- pants with a history of CVD or at higher risk of CVD who used omega-3 supplements, lutein and zeaxathin supplements, or a combination of these, compared to placebo. However, in AMD patients with no history of CVD or at low risk for development of the disease (no CVD, no hypertension, no elevated cholesterol level), omega-3 fatty acid supplementation showed some risk reductions in developing CVD: a statistically signifi- cant 34% reduction in risk of CVD in participants with no history of hypertension, and a non-significant 19% reduction for AMD patients with no history of CVD.

Experts criticized that the study (AREDS2) whose data were analyzed was not designed with enough partici- pants to reasonably detect a significant (defined in the study as a 25%) reduction in composite CVD events (myocardial infarction, stoke and cardiovascular death). With a risk reduction of 10 to 15%, which would be more prudent and realistic for cardiovascular events, and zero side effects, they said omega-3 fatty acids could have an immense impact on CVD risk of the population. The omega-3 fatty acid intakes of AREDS2 participants were significantly below the intakes (above 2 g/day), which were reported in a recent meta- analysis to support reducing blood pressure (2).

References

  1. Writing Group for the AREDS2 Research Group. Effect of Long-Chain Omega-3 Fatty Acids and Lutein + Zeaxanthin Supplements on Cardiovascular Outcomes: Results of the Age-Related Eye Disease Study 2 (AREDS2) Randomized Clinical Trial. JAMA Internal Medicine. Published online March 2014.
  2. Miller P. E. et al. Long-chain omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid and blood pressure: A meta-analysis of randomized controlled trials. Am J Hypertens. Published online March 2014.