Evidence Report/Technology Assessment Number 93

Effects of Omega-3 Fatty Acids on Cardiovascular Risk Factors and Intermediate Markers of Cardiovascular Disease

File Inventory


Prepared by:

Tufts-New England Medical Center EPC
Boston, Massachusetts

Investigators
   Ethan Balk, M.D., M.P.H., Project Leader
   Mei Chung, M.P.H., Research Associate
   Alice Lichtenstein, D.Sc., Primary Technical Expert
   Priscilla Chew, M.P.H., Research Associate
   Bruce Kupelnick, B.A., Research Associate
   Amy Lawrence, M.A., Research Assistant
   Deirdre DeVine, M.Litt., Project Manager
   Joseph Lau, M.D., Principal Investigator


File Name	Description			Software	Version	File	Size
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01front.doc	Microsoft Word® Document	MS Word®	2002	87KB	17 pages
Contents: Title Page, Preface, Acknowledgments, Technical Expert Panel, Structured Abstract, 
Table of Contents
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02body.doc	Microsoft Word® Document	MS Word®	2002	6.0MB	165 pages
Contents: Chapter 1. Introduction: Background; Figure 1.1. Classical omega-3 and omega-6 
  fatty acid synthesis pathways and the role of omega-3 fatty acid in regulating health/disease 
  markers; Table 1.1. Estimates of the meanąstandard error of the mean (SEM) intake of linoleic 
  acid (LA), alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid 
  (DHA) in the United States population, based on analyses of a single 24-hour dietary recall 
  of NHANES III data; Table 1.2. Mean, range, median, and standard error of the mean (SEM) of 
  usual daily intakes of linoleic acid (LA), total omega-3 fatty acids (n-3 FA), alpha-linolenic 
  acid (ALA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid 
  (DHA) in the US population, based on CSFII data (1994-1996, 1998); Relationship of Dietary Fat 
  and Cardiovascular Disease; Omega-3 Fatty Acids and Cardiovascular Disease Risk Factors; 
  Table 1.3. The omega-3 fatty acid content, in grams per 100 g food serving, of a representative 
  sample of commonly consumed fish, shellfish, and fish oils, and nuts and seeds, and plant oils 
  that contain at least 5 g omega-3 fatty acids per 100 g (from USDA website http://www.nal.usda.
  gov/fnic/foodcomp, 2003); Association of Omega-3 Fatty Acid Intake and Tissue Levels; 
Chapter 2. Methods: Overview; Key Questions Addressed in this Report; Analytic Framework; 
  Figure 1.2. Analytic framework for omega-3 fatty acid exposure and cardiovascular disease; 
  Literature Search Strategy; Study Selection; Data Extraction Process; Meta-Regression; 
  Grading Evidence; Reporting Results; Evidence and Summary Tables; Methodological Limitations; 
Chapter 3. Results: Summary of Studies Found; Table 3.1. Numbers of studies of omega-3 fatty acids 
  and cardiovascular risk factors; Lipids: Total Cholesterol; Table 3.2. Effects of omega-3 fatty 
  acids on total cholesterol (mg/dL) in randomized trials (6 weeks to 2 years); Lipids: Low Density 
  Lipoprotein; Table 3.3. Effects of omega-3 fatty acids on low density lipoprotein (mg/dL) in 
  randomized trials (6 weeks to 2 years); Lipids: High Density Lipoprotein; Table 3.4. Effects of 
  omega-3 fatty acids on high density lipoprotein (mg/dL) in randomized trials (6 weeks to 2 years); 
  Lipids: Triglycerides; Table 3.5. Effects of omega-3 fatty acids on triglycerides (mg/dL) in 
  randomized trials (6 weeks to 2 years); Figure 3.1. Meta-regression of baseline triglyceride (Tg) 
  level versus net change in Tg; Figure 3.2. Meta-regression of dose of EPA+DHA intake versus net 
  change in triglycerides (Tg); Lipoprotein(a); Table 3.6. Effects of omega-3 fatty acids on 
  lipoprotein (a) (mg/dL) in randomized trials (4 weeks to 14 months); Apolipoprotein A-I; 
  Table 3.7. Effects of omega-3 fatty Acids on apolipoprotein A-I (mg/dL) in randomized trials 
  (4 weeks to 2 years); Apolipoprotein B, Apolipoprotein B-100, and LDL Apolipoprotein B; 
  Table 3.8.  Effects of omega-3 fatty acids on apolipoprotein B (mg/dL) in randomized trials 
  (4 weeks to 2 years); Table 3.9. Effects of omega-3 fatty acids on apolipoprotein B-100 and LDL 
  apolipoprotein B (mg/dL) in randomized trials (1 month to 14 months); Blood Pressure; Table 3.10. 
  Effects of omega-3 fatty acids on systolic blood pressure (mm Hg) in randomized trials of diabetic 
  subjects (6 weeks to 1 year); Table 3.11. Effects of omega-3 fatty acids on diastolic blood pressure 
  (mm Hg) in randomized trials of diabetic subjects (6 weeks to 1 year); Hemoglobin A1c; Table 3.12. 
  Effects of omega-3 fatty acids on hemoglobin A1c (%) in randomized trials (4 weeks to 1 year); 
  Fasting Blood Sugar; Table 3.13. Effects of omega-3 fatty acids on fasting blood sugar (mg/dL) 
  in randomized trials (4 weeks to 2 years); Fasting Insulin; Table 3.14. Effects of omega-3 fatty 
  acids on fasting insulin (pmol/L) in randomized trials (4 weeks to 9 months); C-Reactive Protein; 
  Table 3.15. Effects of omega-3 fatty acids on C-reactive protein (mg/L) in studies (4 wk to 3 mo or 
  cross-sectional); Fibrinogen; Table 3.16. Effects of omega-3 fatty acids on fibrinogen (g/L) in 
  randomized trials (4 weeks to 2 years); Factor VII, Factor VIII, and von Willebrand Factor; 
  Table 3.17. Effects of omega-3 fatty acids on factor VII activity (%) in randomized trials 
  (4 weeks to 9 months); Table 3.18. Effects of omega-3 fatty acids on factor VIII activity (%) 
  in randomized trials (6 weeks to 1 year); Table 3.19. Effects of omega-3 fatty acids on 
  von Willebrand factor in randomized trials (4 weeks to 2 years); Platelet Aggregation; 
  Table 3.20. Effects of omega-3 fatty acids on platelet aggregation in randomized trials (4 to 
  15 weeks); Coronary Artery Restenosis; Table 3.21. Effects of omega-3 fatty acids on restenosis 
  in randomized trials (approximately 3 months to 1 year); Figure 3.3. Random effects model of effect 
  of fish oil on coronary artery restenosis following percutaneous transluminal coronary angioplasty; 
  Carotid Intima-Media Thickness; Table 3.22. Effects of omega-3 fatty acids on carotid intima-media 
  thickness (mm) in studies (2 yr or cross-sectional); Exercise Tolerance Test; Table 3.23. Effects of 
  omega-3 fatty acids on treadmill and bicycle exercise tolerance tests in studies (6 weeks-6 months); 
  Heart Rate Variability; Table 3.24. Effects of omega-3 fatty acids on heart rate variability - 
  SD of RR (msec) - in studies (12 weeks or cross-sectional); Tissue Levels of Dietary Omega-3 Fatty 
  Acids; Table 3.25. Studies reporting plasma/serum, platelet, erythrocyte, and other phospholipid 
  changes; Table 3.26. Association of EPA+DHA consumption and tissue levels. Meta-Regression Results; 
  Table 3.27. Effect of omega-3 fatty acid supplementation on fatty acid profile of serum/plasma 
  phospholipids in randomized trials (6 weeks to 14 months); Table 3.28. Effect of omega-3 fatty acid 
  supplementation on fatty acid profile of platelet phospholipids in randomized trials (6 weeks to 
  4 months); Table 3.28. Effect of omega-3 fatty acid supplementation on fatty acid profile of 
  platelet phospholipids in randomized trials (6 weeks to 4 months); Table 3.29. Effect of omega-3 
  fatty acid supplementation on fatty acid profile of red blood cell (erythrocyte) membrane/ghosts 
  in randomized trials (6 weeks to 2 years); Table 3.30. Effect of omega-3 fatty acid supplementation 
  on fatty acid profile of granulocyte membrane in randomized trials (12 weeks); Table 3.31. Effect 
  of omega-3 fatty acid supplementation on fatty acid profile of monocyte phospholipids in randomized 
  trials (8 weeks); Figure 3.4. Association between EPA and/or DHA supplementation and changes in 
  EPA+DHA composition in plasma or serum phospholipids (PL); Figure 3.5. Association between EPA 
  and/or DHA supplementation and changes in EPA+DHA composition in platelet phospholipids (PL); 
  Figure 3.6. Association between EPA and/or DHA supplementation and changes in EPA+DHA composition 
  in red blood cell (RBC, erythrocyte) membrane phospholipids (PL); 
Chapter 4. Discussion: Overview; Main Findings; Limitations; Future Research; 
References and Included Studies; Bibliography of Included Studies; Listing of Excluded Studies
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03acro.doc	Microsoft Word® Document	MS Word®	2002	90KB	3 pages
Contents: List of Acronyms/Abbreviations
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AHRQ Publication No. 04-E010-2
Current as of March 2004


Internet Citation:

Effects of Omega-3 Fatty Acids on Cardiovascular Risk Factors and Intermediate Markers of Cardiovascular Disease. File Inventory, Evidence Report/Technology Assessment Number 93. AHRQ Publication No. 04-E010-2, March 2004. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/o3cvrinv.htm


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