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European Doctors Prescribe Fish Oil After Heart Attacks

Although heart-attack survivors in Europe are routinely prescribed fish oil, this practice is rarely followed in the United States, according to a recent report in the New York Times.

In numerous studies, fish oil rich in omega-3 fatty acids has been shown to improve survival after heart attacks and to reduce fatal heart rhythms. In the US, however, heart attack victims are rarely given omega-3 fatty acids, though they are routinely prescribed more expensive and invasive treatments, such as cholesterol-lowering drugs and implantable defibrillators.

Dr. Terry Jacobson, a preventive cardiologist at Emory University in Atlanta, told the Times, “Most cardiologists here are not giving omega-3s, even though the data support it—there’s a real disconnect. They have been very slow to incorporate the therapy.”

Wide variations in cardiac care around the world underscore the decisive role that drug companies play in disseminating medical information, according to the Times report. Because prescription fish oil is not licensed to prevent heart disease in the US, drug companies may not legally promote it for that purpose, and doctors routinely fail to recommend it to their patients.

According to a recent study published in the Journal of the American Board of Family Medicine, only 17% of family doctors were likely to prescribe fish oil to their patients, including those who had suffered a heart attack. The authors concluded that there was a great need to “improve awareness of this important advice.”

In a landmark study of fish oil conducted more than a decade ago, Italian researchers from the GISSI Group gave 11,000 patients 1 gram of prescription fish oil a day after they had suffered a heart attack. After three years, the number of deaths was reduced by 20% and the number of sudden deaths by 40% compared to a control group. By 2004, medical regulatory authorities in almost all European countries, including Spain, France and Britain, had approved prescription fish oil for use in heart attack patients. The American College of Cardiology now advises patients with coronary artery disease to increase their consumption of omega-3 acids to 1 gram a day.

Dr. Maria Franzosi, a researcher at the Mario Negri Institute in Milan, told the Times that the use of fish oil “is very popular here in Italy, I think partly because so many cardiologists in this country participated in the studies and were aware of the results. In other countries, uptake may be harder because doctors think of it as just a dietary intervention.”

Research on fish oil continues to gain momentum in Europe. Researchers from the GISSI Group are now conducting two major trials to examine fish oil’s effects in patients with abnormal heart rhythms and in patients with heart failure.


Rosenthal E. In Europe it’s fish oil after heart attacks, but not in US. New York Times. October 3, 2006.

Key concepts: Fish oil, European Doctors, heart attack