New Insights Into Mechanisms of Action for Omega-3 Fatty Acids in Atherothrombotic Cardiovascular Disease.

Mason R. Preston
Current atherosclerosis reports, 2019

Abstract

Purpose of review

Treatment of hypercholesterolemia with statins results in significant reductions in cardiovascular risk; however, individuals with well-controlled low-density lipoprotein cholesterol (LDL-C) levels, but persistent high triglycerides (TG), remain at increased risk. Genetic and epidemiologic studies have shown that elevated fasting TG levels are associated with incident cardiovascular events. At effective doses, omega-3 fatty acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), lower TG levels but may have additional atheroprotective properties compared to other TG-lowering therapies such as niacin and fibrates. The purpose of this review is to evaluate mechanisms related to the potential benefits of omega-3 fatty acids in atherothrombotic disease.

Recent findings

Large randomized clinical trials are currently under way to test the cardiovascular benefits of omega-3 fatty acids at a pharmacologic dosage (4 g/day). A large randomized trial with a prescription EPA-only formulation was shown to reduce a composite of cardiovascular events by 25% in statin-treated patients with established cardiovascular disease or diabetes and other CV risk factors. EPA and DHA have distinct tissue distributions as well as disparate effects on membrane structure and lipid dynamics, rates of lipid oxidation, and signal transduction pathways. Compared to other TG-lowering therapies, EPA has been found to inhibit cholesterol crystal formation, inflammation, and oxidative modification of atherogenic lipoprotein particles. The anti-inflammatory and endothelial benefits of EPA are enhanced in combination with a statin. Omega-3 fatty acids like EPA only at a pharmacologic dose reduce fasting TG and interfere with mechanisms of atherosclerosis that results in reduced cardiovascular events. Additional mechanistic trials will provide further insights into their role in reducing cardiovascular risk in subjects with well-managed LDL-C but elevated TG levels.

Keywords

Atherosclerosis; Cholesterol; Eicosapentaenoic; Lipoproteins; Omega-3 fatty acids; Triglycerides.

The best supplements with Omega-3 Acids in Cardiovascular Support category:

• Liquid Omega-3, Deep Sea Fish Oil EPA/DHA, Natural Orange Flavor, 16 fl oz (480 ml) (Nature's Answer) -

  Omega-3 Fish Oil provides, molecularly distilled, nitrogen flushed fish body oil, harvested in the cold, clean waters of the North Atlantic. It contains among others: Omega-3 Acids.

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• Marine Algae Derived Vegan Omega-3, 120 Softgels (Zenwise Health) - M It contains among others: Omega-3 Acids.
• Omega-3 Fish Oil, Ultra-Pure Cold-Water Fish Oil, 180 Softgels (ALLMAX Nutrition) - Athletes have long known the power of Deep Cold-Water fish oil to attain peak physical performance. It contains among others: Omega-3 Acids.
• Fish Oil, 1,000 mg, 300 Softgels (21st Century) - EPA and DHA are important Omega-3 fatty acids that supports cardiovascular health as well as being important components of the cells in the body. It contains among others: Omega-3 Acids.
• Omega 3-6-9, 1,300 mg, 120 Softgels (Solgar) - This formula provides a blend of three premium oils - Fish, Flax and Borage. It contains among others: Omega-3 Acids.
• Omega-3, EPA & DHA, Triple Strength, 950 mg, 50 Softgels (Solgar) - Omega 3 950 mg is Solgar's highest concentration of the natural Omega 3 polyunsaturates EPA and DHA from cold-water fish. It contains among others: Omega-3 Acids.
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• Tri-3D Omega, 330 EPA/220 DHA, 90 Softgels (Now Foods) - The natural fish oil concentrate used in this softgel is manufactured under strict quality control standards. It contains among others: Omega-3 Acids.
• Flax Oil, 1000 mg, 120 Veggie Softgels (Now Foods) - Flax oil is a natural reservoir for the omega-3 fatty acids alpha-linolenic acid (ALA). It contains among others: Omega-3 Acids.
• Omega-3, 180 Softgels (Now Foods) - The natural fish oil concentrate is manufactured under strict quality control standards. It contains among others: Omega-3 Acids.
• Neptune Krill Oil, 500 mg, 120 Softgels (Now Foods) - NKO (Neptune Krill Oil) (Euphausia Superba) is known for its unique fatty acid (FA) profile, which includes EPA and DHA, plus phospholipids. It contains among others: Omega-3 Acids.
• High Lignan Flax Oil, 1,000 mg, 120 Softgels (Now Foods) - Flax Oil (Linum Usitatissimum) is a natural reservoir for the omega-3 fatty acid, Alpha-Linolenic Acid (ALA). It contains among others: Omega-3 Acids.
• Omega-3, Molecularly Distilled, 30 Softgels (Now Foods) - This natural fish oil concentrate is manufactured under strict quality control standards. It contains among others: Omega-3 Acids.
• Omega-3 Mini Gels, 180 Softgels (Now Foods) - The Natural Fish Oil concentrate used in this softgel is manufactured under strict quality control standards. It contains among others: Omega-3 Acids.
• Super Omega EPA, Molecularly Distilled, 240 Softgels (Now Foods) - NOW Super Omega EPA has twice the EPA (360 mg per softgel) as in our regular strength product (180 mg per softgel). It contains among others: Omega-3 Acids.
• DHA-500/EPA-250, Double Strength, 180 Softgels (Now Foods) - NOW DHA-500 has twice the DHA (500 mg per softgel) as in our regular strength product (250 mg per softgel). It contains among others: Omega-3 Acids.
• Omega 3-6-9, 1000 mg, 250 Softgels (Now Foods) - Omega 3-6-9 is a blend of Flax-Seed (Linum Usitatissimum), Evening Primrose (Oenothera Biennis), Canola (Brassica Napus) / Omega-9 / Erucic Acid , Black Currant Seed Oils (Ribes Nigrum) - which contains: EPA, DHA, ALA, GLA and Linoleic Acid; and Pumpkin Seed Oils (Cucurbita Pepo). It contains among others: Omega-3 Acids.
• Super Omega 3-6-9, 1200 mg, 180 Softgels (Now Foods) - Super Omega 3-6-9 is a blend of Fish, Borage and Flax Seed Oils (Linum Usitatissimum). It contains among others: Omega-3 Acids.
• Ultra Omega 3-D, 600 EPA/300 DHA, 180 Softgels (Now Foods) - Supportive but not conclusive research shows that consumption of EPA and DHA omega-3 fatty acids may reduce the risk of coronary heart disease. It contains among others: Omega-3 Acids.
• Ultra Omega-3, 500 EPA/250 DHA, 90 Softgels (Now Foods) - Supportive but not conclusive research shows that consumption of EPA and DHA omega-3 fatty acids may reduce the risk of coronary heart disease. It contains among others: Omega-3 Acids.
• Omega-3, 180 EPA/120 DHA, 500 Softgels (Now Foods) - The natural fish oil concentrate used in this softgel in manufactured under strict quality control standards. It contains among others: Omega-3 Acids.
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• Ultra Omega-3, 500 EPA/250 DHA, 180 Softgels (Now Foods) - The Natural Fish Oil Concentrate used in this softgel is manufactured under strict quality control standards. It contains among others: Omega-3 Acids.
• Kid's Chewable DHA, Fruit Flavor, 60 Softgels (Now Foods) - K It contains among others: Omega-3 Acids.

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