- Prescription omega-3 fatty acid drugs can effectively reduce triglyceride levels, and can be safely taken with statin drugs that reduce cholesterol levels by 20-30%
- Raised triglyceride levels are becoming increasingly prevalent in the U.S. due to higher rates of obesity and diabetes
- Triglycerides are a form of fat found in the blood. Levels over 200 mg/dl can result in narrowing of blood vessels (atherosclerosis) and increases heart attack and stroke risk. Also, levels over 500 mg/dl can cause pancreatitis
Prescription omega-3 fatty acid drugs can reduce high
triglyceride levels effectively. Currently, there are two prescription omega-3
fatty acid medications, namely, a formulation containing the fatty acid EPA
(eicosapentaenoic acid) and another drug, a combination of two fatty acids, EPA
(eicosapentaenoic acid) and DHA (docosahexaenoic acid).
A recent review of 17 randomized, controlled clinical trials on high triglyceride levels was undertaken, by an advisory panel of the AHA, which concluded that taking 4 grams daily of either of the available omega-3 prescription drugs is effective in bringing down triglyceride levels and can be safely taken along with statin medicines that lower cholesterol.
The conclusions of this review appear in the American Heart Association journal Circulation.
Findings of the Advisory Panel's Review of Research on Elevated Triglycerides
- In persons with high triglycerides (200 to 499 mg/dL), prescription doses of omega-3 fatty acid drugs containing either EPA alone or EPA+DHA can lower triglyceride levels by 20 to 30%.
- There have been no studies comparing the efficacy of the two formulations in lowering triglyceride levels, i.e., EPA alone or a combination of EPA and DHA, and therefore, the advisory recommends that either formulation can be taken
- Contrary to current belief, formulations containing both EPA and DHA do not increase the "bad" form of cholesterol (LDL-C) in most persons with triglyceride levels between 200-499 mg/dL.
- However, if these drugs are taken by persons with very high triglyceride levels of 500 mg/dL or higher, LDL-C may increase
- Prescription omega-3 drugs are safe and effective in reducing triglyceride levels in patients who take statins for high blood cholesterol
- A recently conducted huge randomized placebo-controlled trial called REDUCE-IT, demonstrated that the EPA-only medication given together with statin medication resulted in a 25% reduction in major heart events such as stroke, heart attack and sudden death in persons with elevated triglyceride levels
- Raised triglyceride levels are becoming increasingly prevalent in the United States, due to higher rates of obesity and diabetes. Nearly a quarter of the US population have triglyceride levels over 150 mg/dl, which falls in the category of borderline high value
- It is also important to rule out and treat underlying conditions such as poorly controlled type 2 diabetes, obesity and hypothyroidism, which can cause elevated triglyceride levels before starting medication.
Report of AHA Science Advisory in 2017A 2017 science advisory of the American Heart Association observed a lack of sufficient scientific research to support the use of omega-3 fatty acid prescription drugs to control high triglyceride levels in the general population.
Before the latest advisory, the FDA had approved prescription omega-3 fatty acid medications only if triglyceride levels are very high above 500 mg/dL. The prescribed dose is 4 gm daily taken with food.
Lifestyle Measures to Lower Triglyceride Levels
- Regular exercise and physical activity
- Weight loss measures
- Avoid sugar and refined carbohydrates
- Regular consumption of fish (at least twice a week) such as salmon, herring, mackerel, and albacore tuna, a good source of omega-3 fatty acids
- Omega-3 Fatty Acids for the Management of Hypertriglyceridemia: A Science Advisory From the American Heart Association - (https://www.ahajournals.org/doi/10.1161/CIR.0000000000000709)