[Fish and omega-3 fatty acids and heart failure]. / Fisk og omega-3-fettsyrer ved hjertesvikt.

BACKGROUND: Oily fish are the main source of marine omega-3 fatty acids, which have beneficial cardiovascular effects. The article gives an overview of studies of the effects of fish and omega-3 fatty acids on the risk of heart failure and on mortality in heart failure patients. MATERIAL AND METHOD: The article is based on selected literature from personal archives, references collected from relevant articles in personal archives and on publications found through PubMed searches. RESULTS: Recent observational studies have indicated that a high intake of fish and marine omega-3-fatty acids as well as increased plasma concentrations of the same fatty acids can reduce both the incidence of heart failure and mortality among elderly people with heart failure, with or without a previous myocardial infarction. A clinical, placebo-controlled study of around 7,000 elderly heart failure patients found a 9% reduction in mortality after treatment with omega-3 fatty acids. The omega-3 fatty acids were additional to other heart failure treatment. The beneficial effects of oily fish and omega-3 fatty acids appear to be associated with a number of haemodynamic and biological mechanisms. INTERPRETATION: A high intake of fish and marine omega-3 fatty acids seems to provide protection against the development of heart failure as well as reducing the mortality of manifest heart failure.

[Alpha-linolenic acid, cardiovascular disease and sudden death]. / Alfalinolensyre, kardiovaskulaer sykdom og plutselig død.

BACKGROUND: Several animal experiments have documented that omega-3 fatty acid alpha-linolenic acid (ALA) (C 18:3, n-3) from vegetable oils has beneficial electrophysiological and antiarrhythmic effects. This may explain the protective effect of ALA against cardiovascular diseases and sudden death. MATERIALS AND METHODS: We have continuously and systematically collected and evaluated relevant literature (observational and secondary prophylactic studies) and here present an overview of the effects of ALA on cardiovascular diseases and sudden death. RESULTS: Several observational studies in healthy individuals and in patients with coronary heart disease have indicated that a diet rich in ALA reduces coronary death and the risk for sudden death. A cross-sectional study has shown a beneficial effect of ALA on the progression of coronary atherosclerosis. Three secondary studies have also indicated beneficial effects of ALA on several cardiovascular end-points. Diet studies do have limitations, and the secondary prophylactic studies have not given a definite answer to whether ALA possesses beneficial cardiovascular effects. INTERPRETATION: On the whole, the observational and secondary prophylactic studies indicate that ALA may have cardioprotective effects in healthy individuals and in patients with coronary heart disease. For those who seldom eat fish and only take small amounts of fish oils, a diet rich on ALA may be an alternative.