Fish Oil Medicine Has Heart-healthy Results in High-risk Patients

Many people consume fish oil to help with heart, eye and brain health. However, most clinical trials involving fish oil have not proven the supplement benefits patients who are at high risk for heart problems—until now.

Researchers involved in the study found a new prescription medicine, called Vascepa, significantly lowers the risk of cardiovascular events in people who have heart disease, diabetes and elevated triglyceride levels. To learn more about the study and what it means for patients, we spoke with Dr. Frank McGrew, cardiologist and director of clinical research at the Stern Cardiovascular Foundation.

Understanding the Vascepa Clinical Trial

The REDUCE-IT study was published in The New England Journal of Medicine and followed 8,179 trial participants for almost five years. Participants were already taking statins to control high cholesterol—but their triglycerides, a type of fat found in the blood, remained high. High levels of triglycerides can harden the arteries and increase the chance of stroke, heart attack and heart disease.

“Researchers wanted to learn if prescribing high doses of purified EPA, a fish oil derivative, could improve patient outcomes,” said McGrew. “The difference between Vascepa and regular, over-the-counter fish oil is significant.”

While regular grocery store fish oils contain EPA, they also contain saturated fats, impurities and DHA, which can raise bad cholesterol levels. Vascepa does not contain DHA, and its active ingredient is highly purified EPA—also called icosapent ethyl.

Trial participants who took Vascepa reduced their risk of heart attack, stroke and other vascular events by 25 percent compared to patients in the placebo group. McGrew suggested these findings could change the guidelines doctors use to treat patients with elevated triglyceride levels.

“We’ve done a lot of research on lipids at the Stern Cardiovascular Foundation,” said McGrew. “This was our first major foray into triglycerides, which are part of the lipid components of the blood. This is probably the biggest advancement in lipid management we’ve seen in 50 years.”

Managing Triglycerides and Heart Health

About half of Americans (47 percent) have at least one risk factor for heart disease—high blood pressure, high cholesterol or smoking. However, these aren’t the only indicators of heart health. As the REDUCE-IT trial shows, lowering triglyceride levels can result in reduced cardiovascular events.

Certain medications can cause high triglycerides in some patients, while others experience elevated triglyceride levels from eating excess calories. Diet and exercise help lower triglycerides, especially low-fat and low-carbohydrate diets—but sometimes, lifestyle modifications are only half of a patient’s triglyceride management plan.

“A healthy lifestyle is very important, but sometimes it’s not enough for everyone,” said McGrew. “When used with diet and exercise, 2 grams of Vascepa twice daily can help lower triglycerides. It’s cost-effective and safe. Side effects, such as joint pain and upset stomach, are quite rare.”

Vascepa is currently approved for people who have very high levels of triglycerides. However, it’s important for all patients to maintain healthy triglyceride levels, especially patients with high blood pressure, high cholesterol, diabetes or a family history of vascular problems or cigarette smoking.

“If you have vascular disease or are at risk to develop it, you need to be checked aggressively,” said McGrew. “The majority of people with vascular disease are not treated aggressively enough. But with enough treatment, we can halt the progression of artery blockage, and in many cases, regress it. In other words, we can dramatically lower future stroke and heart attack risk.”

To learn more, read the REDUCE-IT clinical study or explore heart and vascular care at Baptist. Find a doctor by visiting our Find a Physician page.