Enriched margarines fail to keep heart going on

Giving patients with a history of heart attacks a margarine enriched with omega-3 oils in addition to standard drugs appears to make no difference to their chances of having a repeat attack.

A 40-month study of more than 4,800 patients showed taking low doses of omega-3 fatty acids in margarine did not significantly reduce rates of serious heart attacks and other cardiovascular events, Dutch researchers said on Sunday.

The finding raised questions about the benefits of omega-3, which has been shown in previous studies to make for healthier hearts. The margarines used in the study were developed for the researchers by food and consumer goods giant Unilever.

Doctors, however, are unlikely to rush to change clinical practice. Many already prescribe omega-3 fish oil capsules, including GlaxoSmithKline’s Lovaza, to reduce triglycerides, a type of blood fat linked to clogged arteries.

“It will be viewed as a largely negative study and people who are enthusiasts for omega fatty acids will continue to be enthusiasts and people who are skeptics will continue to be skeptics,” said Scott Wright of the Mayo Clinic in the United States, who was not involved in the research.

Daan Kromhout of Wageningen University, who led the study, told the European Society of Cardiology the lack of efficacy might reflect the good background drug treatment patients were receiving, with 85 per cent on cholesterol-lowering statins, as well as blood pressure and blood-thinning tablets.

“We found the cardiovascular mortality rate in the study population was only half that expected, probably because of their excellent treatment,” he said.

“This may also be why the rate of major cardiovascular events during follow-up was no lower in the fatty acid groups than in the placebo group.”

All the men and women in the Dutch study were aged between 60 and 80 and had suffered a heart attack roughly four years previously.

They were randomly assigned use of one of four margarines on bread instead of their regular spread – one containing no extra omega-3 fatty acids; one with 400 milligrams a day of extra eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA); one with 2 grams of alpha-linolenic acid (ALA); and one with a combination of EPA-DHA and ALA.

Despite the overall negative results, researchers did find there was a reduction in repeat heart attacks and other cardiovascular events in women who took ALA margarine, although this was not statistically significant. Diabetes patients also showed a possible benefit.

The results of the study, which was supported by the Netherlands Heart Foundation, the National Institutes of Health, and Unilever, were also published in the New England Journal of Medicine.

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