Heart disease morbidity and mortality is the foremost public health burden in the United States69 and many countries worldwide.70 Poor diet is a leading cause of CHD burden and one of the leading risk factors related to disability-adjusted life-years.69 Because a diet low in seafood omega-3 fatty acids is reported as a contributor to ischemic heart disease disability-adjusted life-years and is considered a dietary risk factor with potentially significant effects on mortality worldwide,71, 72 authoritative bodies recommend intake of EPA+DHA for heart and overall health.2, 73, 74
Our comprehensive meta-analysis of data from RCTs and prospective cohort studies supports this recommendation. Although not statistically significant, a 6% reduced risk of any CHD event was observed among RCTs, a finding supported by a statistically significant 18% reduced risk of CHD among the prospective cohort studies. From a clinical perspective, our results indicate that EPA+DHA may be associated with reducing CHD risk to a greater extent in populations with elevated triglyceride levels or LDL cholesterol, which are risk factors that impact a significant portion of the general adult population in the United States. Additional RCTs with more homogeneous exposure and outcome classifications with longer follow-up periods may continue to provide a better understanding of the promising beneficial relationship between EPA+DHA and CHD risk.