Fish oil reduces heart disease risk in arthritis patients

ADELAIDE, AUSTRALIA. The potential benefit of oils from fish on rheumatoid arthritis (RA) has been the subject of many previous studies. Overall, the results suggest that fish oil supplements containing the omega 3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) can reduce stiffness and pain. But could these supplements also help reduce the increased risk of cardiovascular disease in RA patients?

A team from the Royal Adelaide Hospital investigated the effects of fish oil supplementation on several cardiovascular risk factors. They recruited 31 early RA patients all taking drug treatment for the condition, of whom 18 also chose to take fish oil. The dose was considered by the researchers to be sufficiently high to have an anti-inflammatory action. After three years of supplementation, data from the patients who did not take fish oil was compared with data from those did and reached a level of EPA greater than 5 per cent of total plasma fatty acids. Arachidonic acid, an omega 6 fatty acid which competes with omega 3 FAs, was lower in participants who reached the required level of EPA. It was 30 per cent lower in platelets and 40 per cent lower in peripheral blood cells. Serum thromboxane B2, a cardiovascular risk factor, was 35 per cent lower. Prostaglandin E2, a compound which RA drug treatment seeks to reduce, was 41 per cent lower.

The oils from fish were also linked to positive changes in blood lipids, and a greater rate of remission after the 3 years – 72 per cent compared to 31 per cent in the non-fish group. The authors conclude that fish oil reduces cardiovascular risk in RA patients, and that this takes places via several biological pathways. They suggest that oils from fish could potentially replace drug treatment for many RA patients. In this study, non-steroidal anti-inflammatory drug use was reduced by 75 per cent in the fish group between the start and finish of the study, compared with 37 per cent in the non-fish group. Added to which, RA drugs may themselves contribute to cardiovascular risk. Fish oil is a cheaper, safer treatment option and could also serve as a preventative measure against RA, the authors conclude.
Cleland, LG, et al. Reduction of cardiovascular risk factors with longterm fish oil treatment in early rheumatoid arthritis. Journal of Rheumatology, published online August 1, 2006

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