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Omega-3, Statin drugs, Diet vs. Heart Disease. Which is best?

The April 11 2005 issue of Archives of Internal Medicine published a review of the effects of various lipid lowering regimens on overall mortality and mortality from coronary heart disease.

Researchers from Basel Institute for Clinical Epidemiology and University Hospital in Basel, Switzerland reviewed 97 clinical trials published between 1965 and 2003 that included 137,140 men and women being treated and 138,976 control subjects.

The analysis compared the association with mortality risk of diet, lipid lowering drugs categorized as statins, fibrates and resins, and the nutritional supplements omega-3 fatty acids (commonly found in fish oils) and niacin.

While the fibrate class of drugs failed to influence overall mortality and mildly elevated non-cardiac mortality, and while diet, resins and niacin appeared to provide insignificant benefits, statins and omega-3 fatty acids significantly lowered both overall and coronary heart disease mortality risk during the trial periods.

The risk of overall mortality was reduced by 13 percent by statins and 23 percent by omega-3 fatty acids compared to the risk experienced by those who did not receive treatment.When the risk of mortality from heart disease alone was analyzed, the use of statin drugs and omega-3 fatty acids were found to lower the risk by 22 and 32 percent, respectively. The superiority of omega-3 acids in lowering the risk of overall and cardiac mortality cannot be explained by an ability to reduce cholesterol, which averaged 2 percent in this meta-analysis compared to an average reduction of 20 percent achieved via the use of statins.

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