Large Multicenter Trial: Omega-3 Supplements Have No Benefit For Patients At Cardiac Risk, But Do Have Some Harm

Results from the STatin Residual Risk Reduction With EpaNova in HiGh CV Risk PatienTs With Hypertriglyceridemia (STRENGTH) double-blind, randomized, multicenter trial from 2014 to 2020 found that in patients with high cardiovascular risk, supplements of Omega-3 Fatty Acids were no better for outcomes than plain old vegetable oil.

Results from the STatin Residual Risk Reduction With EpaNova in HiGh CV Risk PatienTs With Hypertriglyceridemia (STRENGTH) double-blind, randomized, multicenter trial from 2014 to 2020 found that in patients with high cardiovascular risk, supplements of Omega-3 Fatty Acids were no better for outcomes than plain old vegetable oil.

This was not a small trial by a supplement company hoping to correlate something to something, this was 13, 078 patients at 675 academic and community hospitals in 22 countries. Half of those randomized got 4 g/d of omega-3 and half got corn oil, in addition to usual therapies like statins. 

Looking at things like fatal and non-fatal heart attacks and stroke, the results were so overwhelming against any efficacy they ended the trial early. This is a rebuke of suspect epidemiology claims that had correlated fatty fish or omega-3 fatty acids with lower risk of heart issues.

Omega-3 supplements were instead worse for people

On January 8, 2020, the trial ended early after 1,384 events in the study population because it reached the "futility boundary" - it was not statistically possible to show the supplements were helping anyone. There was instead actually higher risk of atrial fibrillation in the Omega-3 CA (Epanova; AstraZeneca) treatment group, along with a greater rate of both gastrointestinal adverse events.

Supplement sales people still have an out. The enrolled patients were on medication due to being high-risk so they can still suggest, since no science can show it, that their supplements will prevent becoming high-risk if people start taking them decades earlier, but like all magic rock thinking, belief is helping people more than the supplement.

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