Higher Blood Levels of EPA and DHA Associated with Lower All-Cause and Cardiovascular Mortality

June 27, 2016


Omega-3 Fatty Acids and Mortality in Patients Referred for Coronary Angiography. The Ludwigshafen Risk and Cardiovascular Health Study
Kleber, M. E, et al., Atheroscler., in press , 2016
Vth Dept. of Medicine, Medical Faculty Mannheim, Heidelberg Univ., Mannheim, Germany


This study evaluated the relationship of the measured long-chain omega-3 status (EPA plus DHA) in adults (average age of 63 years) to their subsequent risk of all-cause and cardiovascular mortality. The baseline levels of EPA and DHA were measured by gas-liquid chromatographic procedures in the red blood cells of 3259 participants (mixed genders) who had been referred for coronary angiography because of chest pain or a positive stress test. The subjects were then followed for a median period of 9.9 years during which a total of 29.9 % died and 18.8 % died specifically from cardiovascular causes.

After adjusting the results for traditional risk factors (circulating lipid/lipoprotein levels, body mass index, blood pressures, smoking, diabetes, exercise, etc), those individuals in the top third (highest tertile) of the subjects with respect to blood levels of EPA, DHA, and the EPA/DHA sum exhibited significantly lower risks for all-cause mortality of 25 %, 16 %, and 22%, respectively, relative to those with blood levels in the bottom third. Those in the top third for EPA and the summed EPA/DHA levels exhibited a significantly lower risk for cardiovascular mortality of 30 % and 22 %, respectively, when compared to subjects in the bottom third.

Dr. Holub's Comments:

The highest tertile for EPA plus DHA levels in the red blood cell biomarker as associated with a significantly lower risk for all-cause and cardiovascular mortality was at or above 6.3 % of the fatty acids as the EPA/DHA sum. Such levels can be readily reached within a few weeks in almost all individuals with average daily intakes of 400-500 mg/day of EPA plus DHA. The latter can be realized within a few weeks via the consumption of a few servings of fatty fish/week (egs., salmon, sardines, mackerel, herring, others) and fortified foods and/or supplementation . While ‘daily intakes’ are routinely recommended in nutritional advice, meeting ‘weekly intakes’ of approx. 3000 mg (EPA plus DHA) as ingested at least twice per week (3-4 days apart) can be expected to maintain blood levels in the so-called ‘low-risk zone’ based on the present study since the turnover rate in the body of EPA/DHA is not as brisk as for most water-soluble vitamins and minerals.

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