Fish Oil, Statin Drugs & Heart Attacks

Results of the Japan EPA Lipid Intervention Study (JELIS), first presented at the American Heart Association’s 2005 Scientific Sessions, were¬†published in the March 31 issue of The Lancet.

The addition of eicosapentaenoic acid (EPA) to low-dose statin therapy significantly reduced the incidence of major coronary events, largely driven by a reduction in unstable angina, when compared with statins alone.

A subgroup analysis of the study, which involved a large number of primary-prevention patients, revealed that statin-treated secondary-prevention patients gained the most benefit from fish-oil supplementation.

The investigators, led by Mitsuhiro Yokoyamam believe the benefit provided by the addition of EPA, a long-chain n-3 polyunsaturated fatty acid, to statin therapy does not appear to be mediated by the effects of cholesterol lowering.

In both treatment groups, there was a 26% reduction in levels of low-density lipoprotein (LDL) cholesterol – bad cholesterol.

“The beneficial effects of EPA could have stemmed from many biological effects that lead to the attenuation of thrombosis, inflammation and arrhythmia, in addition to a reduction of triglycerides,” write the authors.

“Overall, this study shows that EPA, at a dose of 1800 mg per day, is a very promising regimen for prevention of major coronary events, especially since EPA seems to act through several biological mechanisms.”

In an accompanying editorial, Dr. Dariush Mozaffarian notes that the current study should inspire other clinical trials of the effects of fish oil and other dietary factors and habits on cardiovascular health.

“Compared with drugs, invasive procedures, and devices, modest dietary changes are low risk, inexpensive, and widely available,” write Dr. Mozaffarian.

“We must curb our infatuation with downstream risk factors and treatments, and focus on the fundamental risk factors for cardiovascular disease: dietary habits, smoking, and physical activity.

If the millions of heart attacks occurring each year were not a clarion call, the obesity epidemic certainly should be.”

Dr. Hooper’s Comment

This an important article for all those who take statin drugs.

Statin drugs are sold under a variety of names including Lipitor (atorvastatin), Zocor (simvastatin), Mevacor (lovastatin) and Pravachol (pravastatin).

Many Australians take statin drugs to help lower their cholesterol, making it one of the most popular classes of prescription drugs on the market today, but like many prescription medications, these drugs are often unnecessary. With a few dietary and lifestyle changes, many people cold lower their LDL (bad) cholesterol and avoid the need for statin drugs.

However, we live in a world where people are looking for a quick fix. And the problem with a ‘quick fix’ is that they can end up doing more harm than good.

Proponents of Lipitor and other statin drugs claim that they, in addition to normalizing cholesterol levels, can reduce inflammation and reduce the risk of heart attack, stroke and heart-related deaths in general.

What doctors and pharmacists are less likely to explain in full to patients, however, are the potential side effects of drugs like Lipitor – side effects that can outweigh any potential good the drugs might purport to do.

Dr. Matthew Budoff, author of “Enhancing Heart Health,” writes that cholesterol-lowering drugs like Lipitor “work by inhibiting the enzyme needed to manufacture cholesterol in the liver.

However, these drugs also block the manufacture of important nutrients like CoQ10, which has been shown to benefit heart health. The other main drawback of this class of drugs is debilitating muscle pain.

Other side effects, according to the Physicians Desk Reference, include liver problems, nausea, diarrhea, abdominal pain, headaches and skin rash.”

Aching muscles are especially common among statin drug users, and according to Bottom Line Yearbook 2002, muscle ache can actually be a sign that body tissues are breaking down, which can lead to serious kidney damage.

So if you are taking a statin medication, there are few things you need to consider:

  • Use a quality fish oil . According the study; ‘EPA, at a dose of 1800 mg per day, is a very promising regimen for prevention of major coronary events’. That is; the use of quality fish oil will help reduce your chance of a heart attack.
  • Use a good source of Coenzyme Q10. Statin drugs dangerously reduce the amount of Coenzyme Q10 within the body. If you take a statin drug you MUST supplement with CoQ10.
  • Supplement with Magnesium. Magnesium is important in helping muscle tissue repair. High dose magnesium will also reduce muscular pains and discomfort. Magnesium will also assist in irregular heart beat and tachycardia.
  • Modify your diet as outlined in the Health Promoting Nutrition. There is more to maintaining a health heart than eating low fat margarine (don’t do it) and Weight Watchers deserts (full of preservatives).