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Omega-3 supplements linked to an increased risk of AF in people with high blood lipids.

According to a study published in the European Heart Journal — Cardiovascular Pharmacotherapy, people with high blood lipids who take omega-3 supplements, also known as “fish oil supplements”, may be at increased risk of developing atrial fibrillation (AF). The authors Dr Salvatore Carbone (Virginia Commonwealth University, USA) and colleagues state that the potential risk of AF should be considered when such supplements are being prescribed or bought over the counter.

A press release reports that previous studies have suggested that omega-3 fatty acids may be associated with an increased risk for AF. However, it adds that these studies tested different formulations of omega-3 fatty acids at different doses. Therefore, Carbone et al performed a comprehensive meta-analysis of randomised controlled trials to try to answer the question of whether fish oils were consistently related to a raised risk for AF.

The authors reviewed data from five randomised controlled trials that had explored the effects of omega-3 fatty acid supplementation on cardiovascular outcomes. Overall, they identified 50,277 participants who had received fish oils or placebo and who had been followed up for between two and 7.4 years. Participants in the studies had elevated triglycerides and were either at high risk for cardiovascular disease or had established cardiovascular disease. The dose of fish oils varied from 0.84g to 4g per day.

Carbone et al found that omega-3 fatty acid supplementation was associated with a significantly increased risk for AF compared to placebo with an incidence rate ratio of 1.37 (95% confidence interval 1.22–1.54; p<0.001). “Currently, fish oil supplements are indicated for patients with elevated plasma triglycerides to reduce cardiovascular risk. Due to the high prevalence of elevated triglycerides in the population, they can be commonly prescribed. Of note, low dose omega-3 fatty acids are available over the counter, without the need for a prescription,” Dr Salvatore Carbone said.

He added: “Our study suggests that fish oil supplements are associated with a significantly greater risk of AF in patients at elevated cardiovascular risk. Although one clinical trial indicated beneficial cardiovascular effects of supplementation, the risk for AF should be considered when such agents are prescribed or purchased over the counter, especially in individuals susceptible to developing the heart rhythm disorder.”

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