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High Cholesterol Message Board

High Cholesterol Board Index

A study in the April 2005 issue of Archives of Internal Medicine examines all randomized, controlled trials published between 1965 and 2003 that compared a lipid lowering strategy with a placebo or usual care. The authors determined that 97 studies met their eligibility criteria. Combining all these studies they were able to examine over 130,000 people in treatment groups compared with an almost equal number of people in control groups.

The authors found that compared with the control groups the risk ratio for death was reduced by 23% for omega-3 (or n-3) fatty acids, 16% for resins, 13% for statins, 4% for niacin, 3% for diet, and 0% for fibrates. “Our study confirms the benefit of statins in reducing the risk of overall cardiac mortality in patients with or without CHD [Coronary Heart Disease] and additionally shows that n-3 fatty acids reduce overall and cardiac mortality in patients with CHD.”

They note that in the class of medications, fibrates, there was “no reduction in overall mortality and an increased risk of death from noncardiovascular causes in individuals taking fibrates compared with individuals in placebo or control groups.”

If used at a correct dosage, omega-3 fatty acids are just as effective as fibrates at reducing triglyceride levels, but unlike fibrates they are associated with an overall reduction in mortality. However, omega-3 fatty acids only slightly lower cholesterol, which means that their benefit is also through other mechanisms. “Studies suggest that n-3 fatty acids may have antiarrhythmic properties with membrane bilizing effects in addition to an antithrombotic and anti-inflammatory properties on the endothelial level.”

Omega-3 fatty acids include eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA), both found primarily in oily cold-water fish such as mackerel, salmon, and tuna. Apart from seaweed, plant foods rarely contain EPA or DHA. Alpha-linolenic acid (ALA), is found primarily in dark green leafy vegetables, flaxseed oils, pumpkin seeds, walnuts, and certain vegetable oils. There are no known side effects associated with increasing your intake of omega-3 fatty acids through foods, although fish oil capsules do pose the risk of an unpleasant, fishy aftertaste that occurs with some brands of fish oil capsules. In addition, omega-3 fatty acids may increase the blood-thinning effects of warfarin or aspirin.

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