Omega-3 Fatty Acids and Risk for Cardiovascular Disease

The long-chain marine n-3 fatty acids have been reported to be cardio protective over many years and many mechanisms of action have been proposed. Up through the first decade of the 21st century, nearly all n-3 randomized trials were positive, but beginning in 2010 several trials were published that did not show a benefit of these fatty acids on clinical cardiovascular endpoints. There is a wealth of epidemiologic evidence for a cardiac benefit for the n-3 fatty acids that appears to contradict the findings of the randomized trials. This chapter will review both trial and prospective cohort study data which, in the aggregate, continues to support the view that n-3 fatty acids are heart healthy.