Prescription omega-3 Fatty Acid Products Containing Highly Purified Eicosapentaenoic Acid (EPA).

Brinton Eliot A., Mason R. Preston
Lipids in health and disease, 2017

Abstract

The omega-3 fatty acid eicosapentaenoic acid (EPA) has multiple actions potentially conferring cardiovascular benefit, including lowering serum triglyceride (TG) and non-high-density lipoprotein cholesterol (non-HDL-C) levels and potentially reducing key steps in atherogenesis. Dietary supplements are a common source of omega-3 fatty acids in the US, but virtually all contain docosahexaenoic acid (DHA) in addition to EPA, and lipid effects differ between DHA and EPA. Contrary to popular belief, no over-the-counter omega-3 products are available in the US, only prescription products and dietary supplements. Among the US prescription omega-3 products, only one contains EPA exclusively (Vascepa); another closely related prescription omega-3 product also contains highly purified EPA, but is approved only in Japan and is provided in different capsule sizes. These high-purity EPA products do not raise low-density lipoprotein cholesterol (LDL-C) levels, even in patients with TG levels >500 mg/dL, in contrast to the increase in LDL-C levels with prescription omega-3 products that also contain DHA. The Japanese prescription EPA product was shown to significantly reduce major coronary events in hypercholesterolemic patients when added to statin therapy in the Japan EPA Lipid Intervention Study (JELIS). The effects of Vascepa on cardiovascular outcomes are being investigated in statin-treated patients with high TG levels in the Reduction of Cardiovascular Events With EPA-Intervention Trial (REDUCE-IT).

Keywords

Cardiovascular disease; Cholesterol; Drug therapy; Eicosapentaenoic acid; Ethyl icosapentate; Hypertriglyceridemia; Icosapent ethyl; Inflammation; Omega-3 fatty acids; Triglycerides.

The best supplements with Eicosapentaenoic Acid in Cardiovascular Support category:

• Organic Flax Seed Oil, 1,000 mg, 90 Softgels (Zahler) - Cold Pressed Flaxseed OilZehaler Flaxseed Oil is high in alpha-linolenic acid (ALA), which is partially converted by the body into other important nutrients like DHA and EPA, Cold pressed from organic flax seeds, Zahler's Flaxseed Oil is 100% pure and natural, unmodified by chemical refinements. It contains among others: Eicosapentaenoic Acid.
• 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: Eicosapentaenoic Acid.

• Liquid Norwegian Cod Liver Oil, Natural Lemon-Lime Flavor, 16 fl oz (480 ml) (Nature's Answer) - Nature’s Answer Liquid Cod Liver Oil is harvested from the deep, clean, cold waters of the North Atlantic. It contains among others: Eicosapentaenoic Acid.
• Marine Algae Derived Vegan Omega-3, 120 Softgels (Zenwise Health) - M It contains among others: Eicosapentaenoic Acid.
• 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: Eicosapentaenoic Acid.
• 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: Eicosapentaenoic Acid.
• 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: Eicosapentaenoic Acid.
• 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: Eicosapentaenoic Acid.
• Omega-3, EPA & DHA, Triple Strength, 950 mg, 100 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: Eicosapentaenoic Acid.
• 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: Eicosapentaenoic Acid.
• Omega-3, 180 Softgels (Now Foods) - The natural fish oil concentrate is manufactured under strict quality control standards. It contains among others: Eicosapentaenoic Acid.
• 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: Eicosapentaenoic Acid.
• 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: Eicosapentaenoic Acid.
• Omega-3, Molecularly Distilled, 30 Softgels (Now Foods) - This natural fish oil concentrate is manufactured under strict quality control standards. It contains among others: Eicosapentaenoic Acid.
• 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: Eicosapentaenoic Acid.
• 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: Eicosapentaenoic Acid.
• 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: Eicosapentaenoic Acid.
• 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: Eicosapentaenoic Acid.
• 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: Eicosapentaenoic Acid.
• 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: Eicosapentaenoic Acid.
• 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: Eicosapentaenoic Acid.
• 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: Eicosapentaenoic Acid.
• Omega-3, 180 EPA/120 DHA, 200 Softgels (Now Foods) - The natural fish oil concentrate used in this softgel is manufactured under strict quality control standards. It contains among others: Eicosapentaenoic Acid.
• 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: Eicosapentaenoic Acid.
• Kid's Chewable DHA, Fruit Flavor, 60 Softgels (Now Foods) - K It contains among others: Eicosapentaenoic Acid.
• Vitabase - Enfūz (Advanced) - Enfūz Advanced is a complete nutritional supplement program designed to meet your basic nutritional needs. It contains among others: Eicosapentaenoic Acid.

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The Eicosapentaenoic Acid:arachidonic Acid Ratio and Its Clinical Utility in Cardiovascular Disease.