Dietary fish oils containing eicosapentaenoic acid and the prevention of atherosclerosis and thrombosis.

Recent epidemiologic studies have shown that rates of cardiovascular disease are lower in populations such as the Greenland Eskimos than in those that do not eat seafood, even though the levels of dietary fat intake are often similar. Dietary fish oils are rich in eicosapentaenoic acid (EPA), a polyunsaturated fatty acid of the omega-3 series. EPA has been shown to prolong bleeding time and to decrease platelet aggregation and blood viscosity. EPA inhibits the production of prostaglandins from endogenous arachidonic acid, which is associated with the formation of thromboxane A2 and may also dampen cyclo-oxygenase and lipoxygenase metabolites involved in mediating endothelial cell proliferation. Dietary fish oils are now available in the form of EPA-enriched capsules. Short-term trials in humans have shown that EPA significantly reduces the levels of plasma triglycerides and may increase the levels of high-density lipoproteins; however, no consistent effect on serum cholesterol levels has been shown. The results of evaluations of EPA's use in patients with renal disorders, mild hypertension, inflammatory disorders or hyperlipidemia have been promising. On the basis of the epidemiologic and biologic evidence dietary fish oils warrant further study in extensive clinical trials.