Omega-3 polyunsaturated fatty acids for the management of dyslipidemia and reduction of residual cardiovascular risk

Introduction. The prescription of statins is a method of prevention and treatment of cardiovascular diseases (CVD) with proven long-term safety and efficacy. Monotherapy with statins reduces the concentration of low-density lipoprotein cholesterol and the overall risk of cardiovascular mortality, but patients remain at residual risk associated with elevated triglyceride level. There is evidence that the residual risk of CVD can be reduced by the use of long-chain ω3 polyunsaturated fatty acids (ω3 PUFAs) − eicosapentaenoic (EPA 20:5 ω3) and docosahexaenoic (DHA 22:6 ω3). At the same time, in relation to reducing the risk of developing cardiovascular events, these acids have shown controversial results.Aim. Based on the analysis of the available literature, analyze the reasons for the discrepancies in the results of studies of CVD outcomes and discuss the heterogeneity of the body’s response to the intake of ω3 PUFAs.Materials and methods. The PubMed database was searched for information over the past five years on selected inclusion criteria. Information requests included the following keywords: “eicosapentaenoic acid, docosahexaenoic acid, hypertriglyceridemia, cardiovascular risk.”Results. The dose, type and ratio of the combination of ω3 PUFAs used may be important in evaluating the effect of ω3 PUFAs in reducing the risk of cardiovascular events and mortality. This review summarizes the latest literature data on the prospects for the use of statins, the combination of EPA+DHA and EPA monotherapy in the treatment of hypertriglyceridemia and reducing the risk of CVD. The heterogeneity of the body’s response to the intake of ω3 PUFAs is discussed.Conclusion. Despite the inconsistency of the results of meta-analyses of the effectiveness of the use of combinations of various types of ω3 PUFAs, it is obvious that further study of the combined use of EPA and DHA, their dosing regimen and combination with statin therapy will make them attractive for reducing the residual risk of CVD.