{"id":336459,"date":"2019-04-01T02:00:00","date_gmt":"2019-04-01T00:00:00","guid":{"rendered":"https:\/\/medizinonline.com\/place-of-omega-3-fatty-acids-and-aspirin-in-primary-prevention\/"},"modified":"2019-04-01T02:00:00","modified_gmt":"2019-04-01T00:00:00","slug":"place-of-omega-3-fatty-acids-and-aspirin-in-primary-prevention","status":"publish","type":"post","link":"https:\/\/medizinonline.com\/en\/place-of-omega-3-fatty-acids-and-aspirin-in-primary-prevention\/","title":{"rendered":"Place of omega-3 fatty acids and aspirin in primary prevention."},"content":{"rendered":"

Hypertension, elevated blood lipids or diabetes are among the risk factors of CHD. Omega-3 fatty acid substitution and aspirin administration are preferred as primary prevention. But is that still in keeping with the times?<\/strong><\/p>\n

<\/p>\n

Almost every heart attack is based on coronary artery disease. All the more important are preventive measures that can prevent its development, especially in patients at risk. A healthy lifestyle with sufficient exercise, a balanced diet, and little stress, in addition to a nicotine stop, certainly takes a high priority in primary prevention. In addition, all guidelines recommend a diet rich in fish and the intake of 1 g fish oil capsules, as Prof. Dr. med. Franz Eberli, Zurich, explained. This was based on study results from the 1980s [1\u20136], in which omega-3 fatty acid substitution was associated with a reduction in cardiovascular mortality.<\/p>\n

However, this hypothesis could not be confirmed in the follow-up studies. Only in open-label studies was there a trend toward an effect. A 2018 Cochrane Review [7] analyzed the results of 79 randomized clinical trials and found little or no effect of omega-3 fatty acids with respect to all-cause mortality, cardiovascular mortality, cardiovascular events, stroke, and arrhythmias. A recently published study [8] in 25,871 patients without cardiovascular disease confirmed the new findings. Taking 1 g fish oil capsule vs. placebo showed no difference in terms of reduction in cardiovascular events.<\/p>\n

Aspirin brings no benefit<\/h2>\n

Similar results were obtained in several studies with different patient groups that investigated the benefits of aspirin in primary prevention. A multicenter study [9] randomized 12,546 patients in a 1:1 ratio to receive 100 mg\/day ASA or placebo. The primary end point was a combination of cardiovascular death, myocardial infarction, unstable angina, or stroke\/transient ischemic attack. One of these events was observed in 269 patients (4.29%) in the verum group versus 281 patients (4.48%) in the placebo group. Accordingly, there was no clear advantage.<\/p>\n

A second study [10] examined the protection of ASA against cardiovascular events in 15,480 diabetic patients with an average age of 63 years. Again, one group was given 100 mg\/day of ASA or placebo. The primary efficacy end point was a severe vascular event. During the follow-up period of 7.4 years, the risk of a vascular event was actually moderately reduced by 12%. However, this benefit was offset by a high number of severe hemorrhagic complications (29% increase). “Accordingly, good treatment of hypertension and lowering cholesterol remain the most important primary preventive measures in high-risk patients,” Prof. Eberli concluded.<\/p>\n

Source: 85th Medical Congress Davos, February 7-9, 2019.<\/em><\/p>\n

 <\/p>\n

Literature:<\/p>\n

    \n
  1. NEJM 1985; 312: 1205-1209.<\/li>\n
  2. NEJM 1985; 313: 820-824.<\/li>\n
  3. Circulation 202; 106: 2747.<\/li>\n
  4. Lancet 189; 334:757-761.<\/li>\n
  5. Lancet 1999; 354: 474-455.<\/li>\n
  6. Circulation 2017; 135: 867-884.<\/li>\n
  7. Cochrane Database Syst Rev 2018; 7: CD03177.<\/li>\n
  8. NEJM 2019; 380: 23-32.<\/li>\n
  9. Lancet 10152; 392: 1036-1046.<\/li>\n
  10. Am Heart J 2018; 198: 135-144.<\/li>\n<\/ol>\n

     <\/p>\n

    GP PRACTICE 2019; 14(3): 40-41
    \nCARDIOVASC 2019; 18(5): 30<\/em>
    \n <\/p>\n","protected":false},"excerpt":{"rendered":"

    Hypertension, elevated blood lipids or diabetes are among the risk factors of CHD. Omega-3 fatty acid substitution and aspirin administration are preferred as primary prevention. But is that still in…<\/p>\n","protected":false},"author":7,"featured_media":87905,"comment_status":"closed","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"pmpro_default_level":"","cat_1_feature_home_top":false,"cat_2_editor_pick":false,"csco_eyebrow_text":"Coronary heart disease","footnotes":""},"category":[11359,11513,11297,11460,11548,11503],"tags":[16457,22229,16779,13446],"powerkit_post_featured":[],"class_list":["post-336459","post","type-post","status-publish","format-standard","has-post-thumbnail","category-cardiology","category-congress-reports","category-general-internal-medicine","category-prevention-and-health-care","category-rx-en","category-studies","tag-aspirin-en","tag-chd-en","tag-coronary-heart-disease-en","tag-hypertension-en-2","pmpro-has-access"],"acf":[],"publishpress_future_action":{"enabled":false,"date":"2026-04-21 14:10:01","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"wpml_current_locale":"en_US","wpml_translations":{"fr_FR":{"locale":"fr_FR","id":336464,"slug":"place-des-acides-gras-omega-3-et-de-laspirine-dans-la-prevention-primaire","post_title":"Place des acides gras om\u00e9ga-3 et de l'aspirine dans la pr\u00e9vention primaire","href":"https:\/\/medizinonline.com\/fr\/place-des-acides-gras-omega-3-et-de-laspirine-dans-la-prevention-primaire\/"},"it_IT":{"locale":"it_IT","id":336472,"slug":"importanza-degli-acidi-grassi-omega-3-e-dellaspirina-nella-prevenzione-primaria","post_title":"Importanza degli acidi grassi omega-3 e dell'aspirina nella prevenzione primaria","href":"https:\/\/medizinonline.com\/it\/importanza-degli-acidi-grassi-omega-3-e-dellaspirina-nella-prevenzione-primaria\/"},"pt_PT":{"locale":"pt_PT","id":336475,"slug":"lugar-dos-acidos-gordos-omega-3-e-da-aspirina-na-prevencao-primaria","post_title":"Lugar dos \u00e1cidos gordos \u00f3mega-3 e da aspirina na preven\u00e7\u00e3o prim\u00e1ria","href":"https:\/\/medizinonline.com\/pt-pt\/lugar-dos-acidos-gordos-omega-3-e-da-aspirina-na-prevencao-primaria\/"},"es_ES":{"locale":"es_ES","id":336494,"slug":"el-lugar-de-los-acidos-grasos-omega-3-y-la-aspirina-en-la-prevencion-primaria","post_title":"El lugar de los \u00e1cidos grasos omega-3 y la aspirina en la prevenci\u00f3n primaria","href":"https:\/\/medizinonline.com\/es\/el-lugar-de-los-acidos-grasos-omega-3-y-la-aspirina-en-la-prevencion-primaria\/"}},"_links":{"self":[{"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/posts\/336459","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/comments?post=336459"}],"version-history":[{"count":0,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/posts\/336459\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/media\/87905"}],"wp:attachment":[{"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/media?parent=336459"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/category?post=336459"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/tags?post=336459"},{"taxonomy":"powerkit_post_featured","embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/powerkit_post_featured?post=336459"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}