High-dose omega-3 fish oil supplementation reduced serious cardiovascular events in adults on hemodialysis. Digest
Hemodialysis, a blood-filtering therapy for patients with kidney failure, saves lives, yet cardiovascular disease remains the dominant cause of death in this group. With few proven preventive options, researchers tested whether high-dose omega-3 supplementation could reduce major heart and vascular events in dialysis care.
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In a randomized controlled trial across 26 centers in Canada and Australia, 1,228 adults receiving maintenance hemodialysis took either four fish-oil capsules daily (4 g/day of omega-3 fatty acids, including 1.6 g of EPA and 0.8 g of DHA) or a corn-oil placebo and were followed for up to 3.5 years for serious cardiovascular events, including heart-related death, heart attack, stroke, and circulation problems leading to amputation.
- Over the study period, the risk of serious cardiovascular events was 43% lower in the fish-oil group than in the placebo group.
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Roughly one in five people taking fish oil experienced at least one major cardiovascular event, compared with about one in three in the placebo group.
- When deaths from non-heart causes were added, total events were still 23% lower in the fish-oil group.
- Each major cardiovascular outcome occurred less often with fish oil, rather than the benefit being driven by one type of event.
- The apparent benefit was similar in participants with and without prior cardiovascular disease.
- Serious bleeding, which was a principal safety concern evaluated in the trial, was not more frequent in the fish-oil group.
Hemodialysis is characterized by a pro-inflammatory and pro-arrhythmic environment, with rapid shifts in fluid and electrolytes that can stress the heart and blood vessels. Omega-3 fatty acids may counter these stresses by calming inflammation, reducing clot formation, and stabilizing heart rhythms through effects on cell membranes of the heart. These combined actions could explain the broad reduction in cardiovascular events seen in the trial.
If these findings replicate and translate into practice, omega-3 supplementation could become a practical component of cardiovascular risk reduction in dialysis patients. In episode #68, Dr. Bill Harris and I discuss the roles of omega-3 fatty acids in cardiovascular and neurocognitive health.