Posts Tagged ‘depression and coronary disease’

Stroke Prevention and Omega3 pharmaceutical grade fish oil EPA

Sunday, April 29th, 2012

Stroke Prevention and Omega3 pharmaceutical grade fish oil EPA

In a study based on a hypercholesterolemic patient population in Japan, subjects achieved secondary prevention of stroke with EPA.
In Japanese hypercholesterolemic patients with a history of stroke, EPA supplementation reduced the risk of stroke recurrence by 20%.
Further studies must be conducted with EPA to further understand potential benefits of EPA in stroke prevention.

The long-chain omega-3 fatty acideicosapentaenoic acid 20:5n-3 has been investigated for its role in preventing stroke recurrence. Specifically, the effects of EPA on stroke incidence were investigated as part of a large Japanese study known as the JELIS trial (Japan EPA Lipid Intervention Study). Conducted over a 5-year period, the JELIS trial examined the preventive effect of long-term supplementation with 1800 mg/day EPA on major coronary events and stroke in hypercholesterolemic patients in Japan
This large trial included over 18,000 individuals (15,000 without existing coronary artery disease and 3,645 with existing coronary artery disease), all between the ages of 40 and 75. All study participants were placed on statin therapy and then randomized in an open-label, endpoint-blinded manner to either an EPA 1800 mg/day group or a control group. The primary endpoint was any major cardiovascular event (sudden death, fatal or non-fatal myocardial infarction, unstable angina, angioplasty, or coronary artery bypass surgery). After a mean follow-up of 4.6 years, it was determined that EPA significantly suppressed the incidence of coronary events

A subanalysis of the JELIS trial was conducted with respect to stroke incidence, to determine whether EPA supplementation reduced the recurrence of stroke . The subanalysis examined the effects of EPA on stroke rates in 942 subjects with a history of stroke. Within this subgroup, stroke occurred in 48 (10.5%) of 457 subjects randomized to the no EPA group, and stroke occurred in 33 (6.8%) of 485 subjects randomized to the EPA group. Thus, EPA supplementation reduced the risk of stroke recurrence by 20%. The number needed to treat (i.e., the number of patients that a doctor would need to treat to prevent one stroke) was 27. These results indicate that 1800 mg/day EPA supplementation achieved secondary prevention of stroke in Japanese hypercholesterolemic patients. Furthermore, EPA supplementation did not raise the risk of subarachnoid hemorrhage or cerebral hemorrhage, indicating that EPA supplementation was safe vis-à-vis stroke risk

It should be noted that the JELIS trial population was exclusively Japanese, and this population exhibits a high background consumption of fish. The JELIS trial was the first to examine the particular effects of EPA on stroke recurrence. The results should inspire future studies to investigate the effects of EPA on stroke prevention in other populations.

Yokoyama M, Origasa H, Matsuzaki M, Matsuzawa Y, Saito Y, Ishikawa Y, Oikawa S, Sasaki J, Hishida H, Itakura H, Kita T, Kitabatake A, Nakaya N, Sakata T, Shimada K, Shirato K. Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet 2007;369:1090-1098.
Matsuzaki M, Yokoyama M, Saito Y, Origasa H, Ishikawa Y, Oikawa S, Sasaki J, Hishida H, Itakura H, Kita T, Kitabatake A, Nakaya N, Sakata T, Shimada K, Shirato K, Matsuzawa Y. Incremental effects of eicosapentaenoic acid on cardiovascular events in statin-treated patients with coronary artery disease. Circ J 2009;73:1283-1290.
Tanaka K, Ishikawa Y, Yokoyama M, Origasa H, Matsuzaki M, Saito Y, Matsuzawa Y, Sasaki J, Oikawa S, Hishida H, Itakura H, Kita T, Kitabatake A, Nakaya N, Sakata T, Shimada K, Shirato K. Reduction in the recurrence of stroke by eicosapentaenoic acid for hypercholesterolemic patients: subanalysis of the JELIS trial. Stroke 2008;39:2052-2058.
Harris WS. Substudies of the Japan EPA Lipid Intervention Study (JELIS). Curr Atheroscler Rep 2009;11:399-400.

Long-Chain Omega-3 Fatty Acid Deficiency in Mood Disorders: Rationale for Treatment and Prevention.

Saturday, September 10th, 2011


Department of Psychiatry, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, OH 45219-0516, USA.


Major recurrent mood disorders including major depressive disorder (MDD) and bipolar disorder (BD) are associated with significant psychosocial morbidity and excess premature mortality primarily attributable to suicide and coronary heart disease. Limited efficacy and adverse side-effects associated with psychotropic medications used in the treatment of MDD and BD highlight the urgent need to develop safe and efficacious treatments or treatment adjuncts. A body of evidence now indicates that long-chain omega-3 (LCn-3) fatty acid deficiency is a feature associated with MDD and BD. The etiology of LCn-3 deficits in MDD and BD patients may be attributable to both genetic and environmental factors. Dietary LCn-3 supplementation is safe and well-tolerated with chronic administration and corrects LCn-3 deficiency in MDD and BD patients. LCn-3 supplementation has been found to augment the therapeutic efficacy of psychotropic medications in the treatment of mood symptoms and to reduce suicidality. Preliminary studies also suggest that LCn-3 supplementation is efficacious as monotherapy in the treatment and prevention of psychopathology in children and adolescents. LCn-3 supplementation may also be associated with reduced risk for developing coronary heart disease. The overall cost-benefit ratio associated with LCn-3 supplementation provides a strong rationale to diagnose and treat LCn-3 deficiency in MDD and BD patients, and to prevent LCn-3 deficiency in subjects at high risk for developing these disorders.

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