References for Medscape Brand Alert

Below are the citations to support the Brand Alert entitled "Omega-3s: A safe, easy and effective way to help protect your patients' cardiovascular health." 

Reduction in Cardiac Death Risk 

Casula M Soranna D Catapano AL and Corrao G (2013). Long-term effect of high dose omega-3 fatty acid supplementation for secondary prevention of cardiovascular outcomes: A meta-analysis of randomized, placebo controlled trials. Atheroscler Suppl. 14:243-251.                  

Chen Q Cheng LQ Xiao TH Zhang YX Zhu M Zhang R Li K Wang Y and Li Y (2011). Effects of omega-3 fatty acid for sudden cardiac death prevention in patients with cardiovascular disease: a contemporary meta-analysis of randomized, controlled trials. Cardiovasc Drugs Ther. 25:259-265.

Delgado-Lista J Perez-Martinez P Lopez-Miranda J and Perez-Jimenez F (2012). Long chain omega-3 fatty acids and cardiovascular disease: a systematic review. Br J Nutr. 107:S201-S213. 

Kotwal S Jun M Sullivan D Perkovic V and Neal B (2012). Omega 3 Fatty acids and cardiovascular outcomes: systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 5:808-818. 

Kwak SM Myung SK Lee YJ and Seo HG (2012). Efficacy of omega-3 fatty acid supplements (eicosapentaenoic acid and docosahexaenoic acid) in the secondary prevention of cardiovascular disease: a meta-analysis of randomized, double-blind, placebo-controlled trials. Arch Intern Med. 172:686-694. 

León H Shibata MC Sivakumaran S Dorgan M Chatterley T and Tsuyuki RT (2008). Effect of fish oil on arrhythmias and mortality: systematic review. BMJ. 337:a2931.

Marik PE and Varon J (2009). Omega-3 dietary supplements and the risk of cardiovascular events: a systematic review. Clin Cardiol. 32:365-372. 

Rizos EC Ntzani EE Bika E Kostapanos MS and Elisaf MS (2012). Association between omega-3 fatty acid supplementation and risk of major cardiovascular disease events: a systematic review and meta-analysis. JAMA. 308:1024-1033. 

Trikalinos TA Lee J Moorthy D Yu WW Lau J Lichtenstein AH and Chung M (2012). Effects of Eicosapentanoic Acid and Docosahexanoic Acid on Mortality Across Diverse Settings: Systematic Review and Meta-analysis of Randomized Trials and Prospective Cohorts. Technical Review 17, Vol. 4. (Prepared by the Tufts Medical Center Evidence-based Practice Center under Contract No. HHSA 290-2007-10055-1.) AHRQ Publication No. 12-EHC040-EF. Rockville, MD: Agency for Healthcare Research and Quality. 

Trikalinos TA Moorthy D Chung M Yu WW Lee J Lichtenstein AH and Lau J (2012). Concordance of randomized and nonrandomized studies was unrelated to translational patterns of two nutrient-disease associations. J Clin Epidemiol. 65:16-29. 

Wang C Harris WS Chung M Lichtenstein AH Balk EM Kupelnick B Jordan HS and Lau J (2006). n-3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review. Am J Clin Nutr. 84:5-17. 

Wen YT Dai JH and Gao Q (2014). Effects of Omega-3 fatty acid on major cardiovascular events and mortality in patients with coronary heart disease: a meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis. 24:470-475. 

Zhao YT Chen Q Sun YX Li XB Zhang P Xu Y and Guo JH (2009). Prevention of sudden cardiac death with omega-3 fatty acids in patients with coronary heart disease: a meta-analysis of randomized controlled trials. Ann Med. 41:301-310. 

Decrease in Triglycerides 

Balk EM Lichtenstein AH Chung M Kupelnick B Chew P and Lau J (2006). Effects of omega-3 fatty acids on serum markers of cardiovascular disease risk: a systematic review. Atherosclerosis. 189:19-30.

Bernstein AM Ding EL Willett WC and Rimm EB (2012). A meta-analysis shows that docosahexaenoic acid from algal oil reduces serum triglycerides and increases HDL-cholesterol and LDL-cholesterol in persons without coronary heart disease. J Nutr. 142:99-104. 

Castro IA Barroso LP and Sinnecker P (2005). Functional foods for coronary heart disease risk reduction: a meta-analysis using a multivariate approach. Am J Clin Nutr. 82:32-40. 

Chi H Lin X Huang H Zheng X Li T and Zou Y (2014). Omega-3 fatty acid supplementation on lipid profiles in dialysis patients: meta-analysis. Arch Med Res. 45:469-477. 

Eslick GD Howe PR Smith C Priest R and Bensoussan A (2009). Benefits of fish oil supplementation in hyperlipidemia: a systematic review and meta-analysis. Int J Cardiol. 136:4-16. 

Farmer A Montori V Dinneen S and Clar C (2008). Fish oil in people with type 2 diabetes mellitus. Cochrane Database Syst Rev. CD003205. 

Friedberg CE Janssen MJ Heine RJ and Grobbee DE (1998). Fish oil and glycemic control in diabetes. A meta-analysis. Diabetes Care. 21:494-500. 

Hartweg J Farmer AJ Perera R Holman RR and Neil HA (2007). Meta-analysis of the effects of n-3 polyunsaturated fatty acids on lipoproteins and other emerging lipid cardiovascular risk markers in patients with type 2 diabetes. Diabetologia. 50:1593-1602. 

Hartweg J Perera R Montori V Dinneen S Neil HA and Farmer A (2008). Omega-3 polyunsaturated fatty acids (PUFA) for type 2 diabetes mellitus. Cochrane Database Syst Rev. CD003205. 

Hooper L Summerbell CD Thompson R Sills D Roberts FG Moore HJ Davey Smith G (2012). Reduced or modified dietary fat for preventing cardiovascular disease. Cochrane Database Syst Rev. 5:CD002137. 

Lohner S Fekete K Marosvölgyi T and Decsi T (2013). Gender differences in the long-chain polyunsaturated fatty acid status: systematic review of 51 publications. Ann Nutr Metab. 62:98-112.

Lorente-Cebrián S Costa AG Navas-Carretero S Zabala M Martínez JA and Moreno-Aliaga MJ (2013). Role of omega-3 fatty acids in obesity, metabolic syndrome, and cardiovascular diseases: a review of the evidence. J Physiol Biochem. 69:633-651. 

Montori VM Farmer A Wollan PC and Dinneen SF (2000). Fish oil supplementation in type 2 diabetes: a quantitative systematic review. Diabetes Care. 23:1407-1415. 

Oliveira JM and Rondó PH (2011). Omega-3 fatty acids and hypertriglyceridemia in HIV-infected subjects on antiretroviral therapy: systematic review and meta-analysis. HIV Clin Trials. 12:268-274. 

Pei J Zhao Y Huang L Zhang X and Wu Y (2012). The effect of n-3 polyunsaturated fatty acids on plasma lipids and lipoproteins in patients with chronic renal failure--a meta-analysis of randomized controlled trials. J Ren Nutr. 22:525-532. 

Stradling C Chen YF Russell T Connock M Thomas GN and Taheri S (2012). The effects of dietary intervention on HIV dyslipidaemia: a systematic review and meta-analysis. PLoS One. 7:e38121. 

Tatsioni A Chung M Sun Y Kupelnick B Lichtenstein AH Perrone R Chew P Lau J and Bonis PA (2005). Effects of fish oil supplementation on kidney transplantation: a systematic review and meta-analysis of randomized, controlled trials. J Am Soc Nephrol. 16:2462-2470. 

Tian H Yao X Zeng R Sun R Tian H Shi C Li L Tian J and Yang K (2013). Safety and efficacy of a new parenteral lipid emulsion (SMOF) for surgical patients: a systematic review and meta-analysis of randomized controlled trials. Nutr Rev. 71:815-821. 

Wei MY and Jacobson TA (2011). Effects of eicosapentaenoic acid versus docosahexaenoic acid on serum lipids: a systematic review and meta-analysis. Curr Atheroscler Rep. 13:474-483. Erratum in: Curr Atheroscler Rep. 2012; 14:93. 

Zheng T Zhao J Wang Y Liu W Wang Z Shang Y Zhang W Zhang Y and Zhong M (2013). The limited effect of omega-3 polyunsaturated fatty acids on cardiovascular risk in patients with impaired glucose metabolism: a meta-analysis. Clin Biochem. 47:369-377.

Zhu W Dong C Du H Zhang H Chen J Hu X and Hu F (2014). Effects of fish oil on serum lipid profile in dialysis patients: a systematic review and meta-analysis of randomized controlled trials. Lipids Health Dis. 13:127. 

Reduction in Blood Pressure 

Cabo J Alonso R and Mata P (2012). Omega-3 fatty acids and blood pressure. Br J Nutr. 107:S195-S200. 

Campbell F Dickinson HO Critchley JA Ford GA and Bradburn M (2013). A systematic review of fish-oil supplements for the prevention and treatment of hypertension. Eur J Prev Cardiol. 20:107–120. 

Geleijnse JM Giltay EJ Grobbee DE Donders AR and Kok FJ (2002). Blood pressure response to fish oil supplementation: metaregression analysis of randomized trials. J Hypertens. 20:1493-1499. 

Miller PE Van Elswyk M and Alexander DD (2014). Long-chain omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid and blood pressure: a meta-analysis of randomized controlled trials. Am J Hypertens. 27:885-896. 

Statistics on Americans, Omega-3s and Cardiovascular Issues

Murphy RA, Yu EA, Ciappio ED, Mehta S, McBurney MI. Suboptimal Plasma Long Chain n-3 Concentrations are Common among Adults in the United States, NHANES 2003-2004. Nutrients. 2015 Dec 9;7(12):10282-9.

Danaei G, Ding EL, Mozaffarian D, Taylor B, Rehm J, Murray CJ, Ezzati M.The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Med. 2009 Apr 28;6(4):e1000058.

References for Dosing Recommendations Chart

1. 2015-2020 Dietary Guidelines - (Accessed: 13th April 2016)
Click here to link to guidelines

2. Fats and fatty acids in human nutrition: report of an expert consultation: 10-14 November 2008, Geneva. (Food and Agriculture Organization of the United Nations, 2010)
Click here to access report

3. International Society for the Study of Fatty Acids and Lipids (ISSFAL). Report of the sub-committee on recommendations for intake of polyunsaturated fatty acids in healthy adults [Internet];Washington, DC: ; 2004
Click here to access report

4. Kris-Etherton PM Harris WS and Appel LJ for the American Heart Association Nutrition Committee (2002). Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease [published correction appears in Circulation 2003;107:512]. Circulation 106:2747–2757
Click here to link to study 

5. Miller, M. et al. Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation 123, 2292–2333 (2011)
 Click here to link to study