Triglycerides are molecules composed of a glycerol molecule bound to three fatty acids. They are the primary component of very-low-density lipoproteins and serve as critical sources of energy. Having high triglycerides (200 to 499 mg/dL) or very high triglycerides (higher than 500 mg/dL) can increase the risk of cardiovascular disease. A recent science advisory from the American Heart Association summarizes the data surrounding the use of prescription omega-3 fatty acids to lower triglyceride levels.
Omega-3 fatty acids are essential for human health. They include alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). ALA is found mainly in plant oils such as flaxseed, soybean, and canola oils. DHA and EPA are found in fish and other seafood. The human body can convert some ALA into EPA and then to DHA, but the process is very inefficient. The Food and Drug Administration has approved prescription omega-3 fatty acids containing EPA and DHA for the treatment of high or very high triglycerides. Most formulations are in doses that provide more than three grams of EPA and DHA (combined) or EPA alone daily.
The authors of the advisory stated that treating very high triglycerides with 4 grams per day of combined EPA and DHA can reduce patients' triglycerides by 30 percent or more. However, at these doses, patients often experience increases in their LDL cholesterol. When given as EPA alone, LDL typically remains unchanged. Treating high triglycerides with combined EPA and DHA or with EPA alone effectively reduces triglycerides and doesn’t increase LDL.
Findings from a large trial investigating the use of 4 grams of EPA per day (along with a statin) to reduce triglycerides demonstrated a 25 percent reduction in major cardiovascular events. Current trials are underway investigating the effectiveness of using combined EPA and DHA in the treatment of high triglycerides.
The authors of the advisory concluded that 4 grams per day of EPA and DHA are effective and safe for reducing triglycerides either alone or as an adjunct to cholesterol-reducing drugs like statins.
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