Quote[/b] ]5. N-3 Fatty Acid Supplements
A number of investigators have reported on beneficial effects of increased N-3 fatty acid intake in patients with coronary artery disease.(76 77 78 79) Several of these studies used supplements containing long-chain N-3 fatty acids (EPA and DHA, or "fish oil"

at doses ranging from 850 mg to 2.9 g/d. Other studies have shown that higher doses (3 to 4 g/d) provided as supplements can reduce plasma triglyceride levels in patients with hypertriglyceridemia.(71) High intakes of fatty fish (1 serving per day) can result in intakes of EPA and DHA of 900 mg/d. Further studies are needed to establish optimal doses of N-3 fatty acids (including EPA, DHA, and alpha-linolenic acid) for both primary and secondary prevention of coronary disease as well as the treatment of hypertriglyceridemia.
For secondary prevention, beneficial effects of a high dose of N-3 fatty acids on recurrent events have been reported in the GISSI trial.79 A 20% reduction in overall mortality (P=0.01) and a 45% reduction in sudden death (P<0.05) after 3.5 years was reported in subjects with preexisting coronary heart disease (who were being treated with conventional drugs) given 850 mg of N-3 fatty acid ethyl esters (as EPA and DHA) either with or without vitamin E (300 mg/d). Other studies have demonstrated beneficial effects of N-3 fatty acids EPA, DHA (1.9 g/d),(77 78) and alpha-linolenic acid (0.8% of energy)(76 77) in subjects with coronary heart disease. Consumption of 1 fatty fish meal per day (or alternatively, a fish oil supplement) could result in an N-3 fatty acid intake (ie, EPA and DHA) of 900 mg/d, an amount shown to beneficially affect coronary heart disease mortality rates in patients with coronary disease.