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Study says fish oil taken with statins helps heart

Results deemed better than when drugs given alone

TOKYO -- Japanese patients who took high doses of fish oil along with statins, the standard treatment to lower cholesterol, had fewer heart attacks and cardiovascular problems than those taking drugs alone, according to a study in the Lancet medical journal.

The researchers, led by Mitsuhiro Yokoyama, a professor at Kobe University Graduate School of Medicine, found that a long-term intake of fish oil plus statins helped high-cholesterol patients reduce the risk of deaths from heart failure by 19 percent compared with patients on the medication alone.

Fish oil contains eicosapentaenoic acid, or EPA, a fatty acid that researchers have long thought contributes to heart health. No major study had previously looked at the effectiveness of adding EPA to supplement statins such as Lipitor, the world's best-selling drug, made by Pfizer Inc., and Zocor, made by Merck & Co.

"This study shows that EPA, at a dose of 1,800 milligrams per day, is a very promising regimen for prevention of major coronary events," Yokoyama said. The study was published in Lancet yesterday.

Japanese sales of drugs for cholesterol and cardiovascular diseases rose 2.4 percent to $3 billion in 2005, according to the health care research firm IMS Health Inc. Top-selling medicines in that therapeutic category include Lipitor, which is marketed in Japan by Astellas Pharma Inc., Daiichi Sankyo Co.'s Mevalotin, and Shionogi & Co.'s Crestor.

The global market for brand-named treatments for cardiovascular illnesses was worth an estimated $76.9 billion in 2006, Lehman Brothers Holdings Inc. said in a report in September.

The study involved 18,645 Japanese people with high cholesterol, with half randomly assigned to take 1,800 milligrams of EPA from fish oil plus a standard statin dosage, and the rest taking only the medicine.

Participants were followed for four to six years. Further studies should be conducted on other populations outside Japan, Yokoyama said.

Japanese people typically consume more fish on a weekly basis than people in other industrialized nations, at amounts higher than the level seen to protect against fatal heart attacks.

Such differences in diet could affect the outcome of similar studies in different populations.

"Compared with drugs, invasive procedures, and devices, modest dietary changes are low risk, inexpensive, and widely available," said Dariush Mozaffarian of Harvard Medical School and Harvard School of Public Health.

He was writing in a comment accompanying the Lancet study.