The Impact of Omega-3 Fatty Acids on the Most Common Cardiovascular Diseases – A Literature Review
DOI:
https://doi.org/10.12775/QS.2025.40.59442Keywords
omega-3 fatty acids, PUFA, EPA, DHA, arterial hypertension, coronary heart disease, atrial fibrillation, heart failureAbstract
Background
Epidemiological data suggest a beneficial effect of omega-3 fatty acids on cardiovascular risk.
Aim of the study
The aim of this literature review is to compile currently available studies and examine the mechanisms of action of omega-3 fatty acids and their application in the most common cardiovascular diseases, such as hypertension, coronary artery disease, atrial fibrillation, and heart failure. The article also analyzes the relationship between clinical and therapeutic effects and factors such as dose, the presence of cardiovascular diseases, and the population under study.
Material and methods
Literature available in the PubMed database was reviewed using the following keywords ,,Omega-3” ,,fish oil” ,,hypertension” ,,heart artery disease” ,,cardiovascular risk”
,, cardiovascular diseases” ,, heart diseases” ,, cardiovascular outcomes” ,,heart failure” ,,anti-inflammatory”
Conclusion
This literature review suggests that omega-3 fatty acids may improve treatment outcomes
in certain cardiology patients. Clinical effects are dose-dependent, and influenced by
the duration of supplementation as well as the population in which they are applied. Regardless of the dose, omega-3 fatty acids do not reduce cardiovascular risk; however, their addition to therapy in patients already undergoing cardiological treatment may offer benefits. Higher doses may exert hypotensive effects, significantly reduce hypertriglyceridemia, and improve left ventricular ejection fraction, although they are associated with an increased risk of atrial fibrillation.
References
1. Zanetti, M., Grillo, A., Losurdo, P., Panizon, E., Mearelli, F., Cattin, L., … Carretta, R. (2015). Omega-3 Polyunsaturated Fatty Acids: Structural and Functional Effects on the Vascular Wall. BioMed Research International, 2015, 1–14. doi:10.1155/2015/791978
2. Dyerberg J, Bang HO. Haemostatic function and platelet polyunsaturated fatty acids in Eskimos. Lancet. (1979) 2:433–5. doi: 10.1016/S0140-6736(79)91490-9
3. Endo, J., & Arita, M. (2016).Cardioprotective mechanism of omega-3 polyunsaturated fatty acids. Journal of Cardiology, 67(1), 22–27.
4. Watanabe Y, Tatsuno I. Prevention of Cardiovascular Events with Omega-3 Polyunsaturated Fatty Acids and the Mechanism Involved. J Atheroscler Thromb. 2020 Mar 1;27(3):183-198. doi: 10.5551/jat.50658. Epub 2019 Oct 3.
5. Brosolo G, Da Porto A, Marcante S, Picci A, Capilupi F, Capilupi P, Bertin N, Vivarelli C, Bulfone L, Vacca A, Catena C, Sechi LA. Omega-3 Fatty Acids in Arterial Hypertension: Is There Any Good News? Int J Mol Sci. 2023 May 30;24(11):9520. doi: 10.3390/ijms24119520.
6. Yang, B., Shi, L., Wang, A. M., Shi, M. Q., Li, Z. H., Zhao, F., … Li, D. (2018). Lowering effects of n-3 fatty acid supplements on blood pressure by reducing plasma angiotensin II in Inner Mongolia hypertensive patients: A double-blind randomized controlled trial. Journal of Agricultural and Food Chemistry. doi:10.1021/acs.jafc.8b05463
7. Kothapalli KS, Ye K, Gadgil MS, Carlson SE, O'Brien KO, Zhang JY, Park HG, Ojukwu K, Zou J, Hyon SS, Joshi KS, Gu Z, Keinan A, Brenna JT. Positive Selection on a Regulatory Insertion-Deletion Polymorphism in FADS2 Influences Apparent Endogenous Synthesis of Arachidonic Acid. Mol Biol Evol. 2016 Jul;33(7):1726-39. doi: 10.1093/molbev/msw049. Epub 2016 Mar 29.
8. Wang Q, Liang X, Wang L, Lu X, Huang J, Cao J, Li H, Gu D. Effect of omega-3 fatty acids supplementation on endothelial function: a meta-analysis of randomized controlled trials. Atherosclerosis. 2012 Apr;221(2):536-43. doi: 10.1016/j.atherosclerosis.2012.01.006. Epub 2012 Jan 20.
9. Miller, P. E., Van Elswyk, M., & Alexander, D. D. (2014). Long-Chain Omega-3 Fatty Acids Eicosapentaenoic Acid and Docosahexaenoic Acid and Blood Pressure: A Meta-Analysis of Randomized Controlled Trials. American Journal of Hypertension, 27(7), 885–896. doi:10.1093/ajh/hpu024
10. Zhang X, Ritonja JA, Zhou N, Chen BE, Li X. Omega-3 Polyunsaturated Fatty Acids Intake and Blood Pressure: A Dose-Response Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc. 2022 Jun 7;11(11):e025071. doi: 10.1161/JAHA.121.025071. Epub 2022 Jun 1.
11. Yang, B., Shi, M.-Q., Li, Z.-H., Yang, J.-J., & Li, D. (2016). Fish, Long-Chain n-3 PUFA and Incidence of Elevated Blood Pressure: A Meta-Analysis of Prospective Cohort Studies. Nutrients, 8(1), 58. doi:10.3390/nu8010058
12. Orringer CE. Icosapent ethyl: Where will it fit into guideline-based medical therapy for high risk atherosclerotic cardiovascular disease? Trends Cardiovasc Med. 2020 Apr;30(3):151-157. doi: 10.1016/j.tcm.2019.04.009. Epub 2019 May 4.
13. Shibabaw T. Omega-3 polyunsaturated fatty acids: anti-inflammatory and anti-hypertriglyceridemia mechanisms in cardiovascular disease. Mol Cell Biochem. 2021 Feb;476(2):993-1003. doi: 10.1007/s11010-020-03965-7. Epub 2020 Nov 11.
14. Baker EJ, Valenzuela CA, De Souza CO, Yaqoob P, Miles EA, Calder PC. Comparative anti-inflammatory effects of plant- and marine-derived omega-3 fatty acids explored in an endothelial cell line. Biochim Biophys Acta Mol Cell Biol Lipids. 2020 Jun;1865(6):158662. doi: 10.1016/j.bbalip.2020.158662. Epub 2020 Feb 11.
15. Feuchtner G, Langer C, Barbieri F, Beyer C, Dichtl W, Friedrich G, Schgoer W, Widmann G, Plank F. The effect of omega-3 fatty acids on coronary atherosclerosis quantified by coronary computed tomography angiography. Clin Nutr. 2021 Mar;40(3):1123-1129. doi: 10.1016/j.clnu.2020.07.016. Epub 2020 Jul 22.
16. Bittner DO, Goeller M, Zopf Y, Achenbach S, Marwan M. Early-onset coronary atherosclerosis in patients with low levels of omega-3 fatty acids. Eur J Clin Nutr. 2020 Apr;74(4):651-656. doi: 10.1038/s41430-019-0551-5. Epub 2020 Jan 2.
17. Aung T, Halsey J, Kromhout D, Gerstein HC, Marchioli R, Tavazzi L, Geleijnse JM, Rauch B, Ness A, Galan P, Chew EY, Bosch J, Collins R, Lewington S, Armitage J, Clarke R; Omega-3 Treatment Trialists’ Collaboration. Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks: Meta-analysis of 10 Trials Involving 77 917 Individuals. JAMA Cardiol. 2018 Mar 1;3(3):225-234. doi: 10.1001/jamacardio.2017.5205.
18. Abdelhamid AS, Brown TJ, Brainard JS, Biswas P, Thorpe GC, Moore HJ, Deane KH, Summerbell CD, Worthington HV, Song F, Hooper L. Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2020 Feb 29;3(3):CD003177. doi: 10.1002/14651858.CD003177.pub5.
19. Yokoyama M, Origasa H, Matsuzaki M, et al. Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet 2007;369:1090-8
20. Fan H, Zhou J, Yuan Z. Meta-Analysis Comparing the Effect of Combined Omega-3 + Statin Therapy Versus Statin Therapy Alone on Coronary Artery Plaques. Am J Cardiol. 2021 Jul 15;151:15-24. doi: 10.1016/j.amjcard.2021.04.013. Epub 2021 May 26.
21. Bhatt, D. L., Steg, P. G., Miller, M., Brinton, E. A., Jacobson, T. A., Ketchum, S. B., … Ballantyne, C. M. (2018). Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia. New England Journal of Medicine. doi:10.1056/nejmoa1812792
22. Lombardi M, Carbone S, Del Buono MG, Chiabrando JG, Vescovo GM, Camilli M, Montone RA, Vergallo R, Abbate A, Biondi-Zoccai G, Dixon DL, Crea F. Omega-3 fatty acids supplementation and risk of atrial fibrillation: an updated meta-analysis of randomized controlled trials. Eur Heart J Cardiovasc Pharmacother. 2021 Jul 23;7(4):e69-e70. doi: 10.1093/ehjcvp/pvab008.
23. Macartney MJ, Peoples GE, McLennan PL. Cardiac Arrhythmia Prevention in Ischemia and Reperfusion by Low-Dose Dietary Fish Oil Supplementation in Rats. J Nutr. 2020 Dec 10;150(12):3086-3093. doi: 10.1093/jn/nxaa256.
24. Harrison RA, Elton PJ. Is there a role for long-chain omega3 or oil-rich fish in the treatment of atrial fibrillation? Med Hypotheses. 2005;64(1):59-63. doi: 10.1016/j.mehy.2004.06.016.
25. Tribulova N, Szeiffova Bacova B, Egan Benova T, Knezl V, Barancik M, Slezak J. Omega-3 Index and Anti-Arrhythmic Potential of Omega-3 PUFAs. Nutrients. 2017 Oct 30;9(11):1191. doi: 10.3390/nu9111191.
26. Abdelhamid AS, Martin N, Bridges C, Brainard JS, Wang X, Brown TJ, Hanson S, Jimoh OF, Ajabnoor SM, Deane KH, Song F, Hooper L. Polyunsaturated fatty acids for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2018 Jul 18;7(7):CD012345. doi: 10.1002/14651858.CD012345.pub2. Update in: Cochrane Database Syst Rev. 2018 Nov 27;11:CD012345. doi: 10.1002/14651858.CD012345.pub3.
27. Herrmann, Wolfgang and Herrmann, Markus. "n-3 fatty acids and the risk of atrial fibrillation, review" Diagnosis, vol. 11, no. 4, 2024, pp. 345-352. https://doi.org/10.1515/dx-2024-0077
28. Lombardi M, Carbone S, Del Buono MG, Chiabrando JG, Vescovo GM, Camilli M, Montone RA, Vergallo R, Abbate A, Biondi-Zoccai G, Dixon DL, Crea F. Omega-3 fatty acids supplementation and risk of atrial fibrillation: an updated meta-analysis of randomized controlled trials. Eur Heart J Cardiovasc Pharmacother. 2021 Jul 23;7(4):e69-e70. doi: 10.1093/ehjcvp/pvab008.
29. Gencer B, Djousse L, Al-Ramady OT, Cook NR, Manson JE, Albert CM. Effect of Long-Term Marine ɷ-3 Fatty Acids Supplementation on the Risk of Atrial Fibrillation in Randomized Controlled Trials of Cardiovascular Outcomes: A Systematic Review and Meta-Analysis. Circulation. 2021 Dec 21;144(25):1981-1990. doi: 10.1161/CIRCULATIONAHA.121.055654. Epub 2021 Oct 6.
30. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A; ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021 Sep 21;42(36):3599-3726. doi: 10.1093/eurheartj/ehab368. Erratum in: Eur Heart J. 2021 Dec 21;42(48):4901. doi: 10.1093/eurheartj/ehab670.
31. Adamo L, Rocha-Resende C, Prabhu SD, Mann DL. Reappraising the role of inflammation in heart failure. Nat Rev Cardiol. 2020 May;17(5):269-285. doi: 10.1038/s41569-019-0315-x. Epub 2020 Jan 22. Erratum in: Nat Rev Cardiol. 2021 Oct;18(10):735. doi: 10.1038/s41569-021-00534-3.
32. Prokopidis K, Therdyothin A, Giannos P, Morwani-Mangnani J, Ferentinos P, Mitropoulos A, Isanejad M. Does omega-3 supplementation improve the inflammatory profile of patients with heart failure? a systematic review and meta-analysis. Heart Fail Rev. 2023 Nov;28(6):1417-1425. doi: 10.1007/s10741-023-10327-0. Epub 2023 Jun 20.
33. Liu J, Meng Q, Zheng L, Yu P, Hu H, Zhuang R, Ge X, Liu Z, Liang X, Zhou X. Effect of n-3 PUFA on left ventricular remodelling in chronic heart failure: a systematic review and meta-analysis. Br J Nutr. 2023 May 14;129(9):1500-1509. doi: 10.1017/S0007114521004979. Epub 2022 Mar 4.
34. J.Seth, S.Sharma, C.J. Leong, S.W. Rabkin Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) ameliorate heart failure through reductions in oxidative stress: a systematic review and meta-analysis Antioxidants (Basel), 13 (8) (2024), p. 955
35. Tseng PT, Zeng BY, Hsu CW, Liang CS, Stubbs B, Chen YW, Chen TY, Lei WT, Chen JJ, Shiue YL, Su KP. The Optimal Dosage and Duration of ω-3 PUFA Supplementation in Heart Failure Management: Evidence from a Network Meta-Analysis. Adv Nutr. 2025 Feb;16(2):100366. doi: 10.1016/j.advnut.2025.100366. Epub 2025 Jan 11.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Jakub Dąbek, Aleksandra Wiśniewska, Wiktoria Kosucka, Dominik Balik, Joanna Lara, Martyna Grabowska, Karolina Grabowska, Anna Kwaśniewska, Karolina Kaszyńska, Jagoda Kubicka
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 63
Number of citations: 0
