HealthDay News — After any underlying causes have been addressed and diet and lifestyle strategies have been implemented, prescription omega-3 fatty acids (n-3 FAs), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) or EPA only, at a dosage of 4 g/d are effective for lowering triglycerides as monotherapy or in combination with other agents, according to an American Heart Association science advisory published in Circulation.

Ann C. Skulas-Ray, PhD, from the University of Arizona in Tucson, and colleagues summarized the lipid and lipoprotein effects resulting from pharmacologic doses of n-3 FAs (>3 g EPA+DHA) on the basis of new scientific data.

The researchers found that treatment of very high triglyceride levels with 4 g/d EPA+DHA reduced triglycerides by ≥30%, with simultaneous increases in low-density lipoprotein cholesterol (LDL-C) levels; however, LDL-C was not raised with EPA only. n-3 FAs with EPA+DHA or EPA only seemed about comparable for triglyceride lowering when used to treat hypertriglyceridemia; when used as monotherapy or in combination with a statin, n-3 FAs with EPA+DHA or EPA only did not increase LDL-C. Non-high-density lipoprotein cholesterol and apolipoprotein B were modestly decreased in the largest trials of 4 g/d prescription n-3 FA. In a randomized trial of EPA only in high-risk patients treated with a statin, use of n-3 FA (4 g/d) resulted in a 25% reduction in major adverse cardiovascular events.

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“We concluded that treatment with 4 grams daily of any of the available prescription choices is effective and can be used safely in conjunction with statin medicines that lower cholesterol,” Dr Skulas-Ray said in a statement.

Several authors disclosed financial ties to the pharmaceutical and nutrition industries.

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