The world’s most important cardiac scientific societies recommend two marine omega-3 fatty acids eicosapentanoic acid (EPA) and docosahexaenoic acid (DHA) for cardiovascular prevention, for secondary prevention, for treatment of cardiac arrhythmias, and for treatment of congestive heart failure (Perk et al, 2012; Smith et al, 2011; Zipes et al, 2006; McMurray et al, 2012). Nevertheless, many cardiologists do not recommend EPA plus DHA, because they consider EPA plus DHA ineffective. The opinion of the cardiologists is based on neutral results of large intervention trials with clinical endpoints, and their meta-analyses. However, scientific societies also consider other scientific data, like epidemiology, mechanisms, and results of intervention trials on surrogate (e.g. blood pressure, laboratory values) and intermediate parameters (e.g. changes in blood vessels).
Substantial amounts of data based on the HS-Omega-3 Index have been generated in the last ten years. This allows a clearer view on the field, and also allows to resolve the discrepancies between the results of the large trials with clinical endpoints, and the other results mentioned. This is supported by results of investigations on bioavailability and by results from measurements of levels of EPA plus DHA in other compartments. More detailed information can be found in current review articles (von Schacky, 2014a-d; Superko et al, 2013; Harris et al, 2013). In short: A low HS-Omega-3 Index is a cardiovascular risk factor. It is equivalent and sometimes even superior to conventional risk factors. A HS-Omega-3 Index in the target range of 8 – 11% is associated with lower total mortality, lower cardiovascular mortality, less sudden death, less fatal and non-fatal myocardial infarctions than a HS-Omega-3 Index below the target range.