Omega-3 plus statins effective for enhanced blood lipid control: Study

05-Oct-2010 - Last updated on 06-Oct-2010 at 15:02 GMT

Combining statins with omega-3 fatty acids may be more effective at managing raised blood lipid levels than statins alone, suggests a new study from Korea.

Six weeks of dual therapy was found to reduce blood levels of triglycerides by 41.0 percent, compared to 13.9 percent in the group receiving only statins (simvastatin), according to new findings published in the European Journal of Clinical Nutrition.

Both groups received a daily poll containing 20mg of simvastatin, while half of the participants also received an addition 4 grams of omega-3 per day, providing 1.86 grams of eicosapentaenoic acid (EPA) and 1.4 grams of docosahexaenoic acid (DHA).

Sixty-two people with high triglyceride levels, ranging from 200 to 499 mg per 100 ml, and total cholesterol levels greater than 200 mg per 100 ml participated in the six week prospective, randomized, open-label study.

“The combination of omega-3 fatty acids plus simvastatin, which achieved a significantly greater reduction of triglycerides without adverse reactions, should be considered as an optimal treatment option for patients with mixed dyslipidemia,” report the researchers, led by Professor Hyo-Soo Kim from the Division of Cardiology in the Department of Internal Medicine at Seoul National University Hospital.

Heart health and beyond

The study appears to support the already extensive data linking omega-3 intakes and improved measures of cardiovascular health. The heart health benefits of consuming oily fish, and the omega-3 fatty acids they contain was first reported in the early 1970s by Dr Jorn Dyerberg and his co-workers in The Lancet and The American Journal of Clinical Nutrition. To date, the polyunsaturated fatty acids (PUFAs) have been linked to improvements in blood lipid levels, a reduced tendency of thrombosis, blood pressure and heart rate improvements, and improved vascular function.

Beyond heart health, omega-3 fatty acids, most notably EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), have been linked to a wide-range of health benefits, including reduced risk of certain cancers, good development of a baby during pregnancy, joint health, and improved behaviour and mood.

Despite such benefits there are still problems with ensuring adequate omega-3 intakes from fatty fish. This has led to a fleet of omega-3-rich concentrates becoming available. Projections by Frost & Sullivan set annual growth for the omega-3 market at an impressive 24 per cent, and the market is estimated to be worth $1.6bn by 2014.

Study details

The participants were randomly assigned to received either the statin therapy alone or in combination with the omega-3 supplements (Omacor, Solvay Pharmaceuticals) for 6 weeks. Fifty people completed the trial with seven drop outs from the combination therapy group and five from the simvastatin-only group. Of those that did complete the study, compliance with the intervention was good, with over 90 percent of statin and omega-3 capsules consumed in the combination group, compared with 87 percent in the statin-only group.

Results showed that the omega-3 plus statin group experienced average decreases in triglyceride levels from 309.2 to 177.7 mg per 100 ml, compared with a reduction from 294.6 to 238.3 mg per 100 ml in the simvastatin-only group.

Additionally, significant reductions were observed in LDL cholesterol levels in both groups, while HDL levels were not affected by either intervention, said the researchers.

Professor Kim and his co-workers note that the results echo those from Western populations (Maki et al . 2008, Am. J. Cardiol., Vol. 102, pp. 429-433 & Davidson et al., 2007, Clin. Ther., Vol. 29, pp. 1354-1367).

“In contrast to the potential serious side effects of combinations of statins with fibrate, a combination therapy of omega-3 fatty acids and simvastatin showed few adverse events,” wrote the researchers. “Thus, it could be considered as good therapeutic choice for patients with mixed dyslipidemia, lowering triglycerides by 40 percent without mitigating LDL cholesterol reduction by statins.”

The study was funded by the Innovative Research Institute for Cell Therapy (IRICT) and the Clinical Research Center for Ischemic Heart Disease in South Korea.

Authors: European Journal of Clinical Nutrition
Published online ahead of print, doi:10.1038/ejcn.2010.195
“Prospective randomized comparison between omega-3 fatty acid supplements plus simvastatin versus simvastatin alone in Korean patients with mixed dyslipidemia: lipoprotein profiles and heart rate variability”
Authors: S-H. Kim, M-K. Kim, H-Y. Lee, H-J. Kang, Y-J. Kim, H-S. Kim

What about omega 3 fats alone?

Posted by Aileen Burford-Mason PhD, 11 October 2010 - 14:54 GMT

You cannot say that combining a statin drug with fish oil is optimal treatment for high triglycerides unless you also examine outcomes if fish oil is used alone. If this research was really honest it would have included a third intervention group, namely the same dose of omega 3 fats with placebo instead of the statin. It is possible that the latter intervention would outperform statins alone. Lets have proper control groups before we draw conclusions.

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