BODY & BRAIN
Fish oil pill may cut
heart disease risk
But the drug was tested only in
patients already taking statins
BODY & BRAIN
Benefits of vitamin D pills questioned
In a study, supplements didn’t prevent heart disease or cancer
BY AIMEE CUNNINGHAM
Cholesterol-lowering drugs may one day
gain a sidekick in the battle against heart
disease. Taking a potent drug derived
from fish oil along with a statin lowers
the risk of heart attack and stroke in
some high-risk people, researchers say.
A clinical trial called REDUCE-IT
tested the approach in over 8,000 participants who either had cardiovascular
disease or were at high risk for it. These
people were already on statins to lower
their cholesterol and had high blood levels of fats called triglycerides.
People took either a two-gram pill of a
highly purified omega- 3 fatty acid — the
oil found in fatty fish — twice daily or a
placebo, and were followed up to six years.
Of the omega- 3 group, 17. 2 percent had a
B Y MARCIA FRELLICK
Taking a vitamin D supplement does not
reduce the risk of having a heart attack or
stroke, or of getting an invasive cancer.
A large clinical trial called VITAL
found no significant difference in cancer
or heart health risk between people taking 2,000 international units of vitamin D
a day and those who took a placebo,
researchers reported November 10.
“What this does show is that the general population does not need to be taking
vitamin D for cardiovascular health
or cancer health,” says Erin Michos,
a preventive cardiologist at Johns
Hopkins University School of Medicine
who wasn’t involved in the trial.
Researchers have long known that
people with low blood levels of vitamin D
are at higher risk for heart attacks,
fatal or nonfatal heart attack or stroke;
22 percent in the placebo group did.
Overall, the drug, called Vascepa,
reduced the risk of heart attack or stroke
by 25 percent, researchers announced
November 10. The results were also
published in the New England Journal
The results are “strikingly positive,”
says Carl Orringer, a cardiologist at
the University of Miami Miller School
of Medicine in Florida who was not
involved in the study. For people taking statins and working to combat high
levels of triglycerides with healthy diet
and exercise, the drug appears to provide
additional benefit, he says.
But he warns that the finding doesn’t
mean that popular, but less potent, sup-
plements containing omega- 3 fatty acids
will have a similar effect. “We don’t want
people to go running out to the drugstore
to buy a fish oil pill,” Orringer says. “It
won’t help them.”
Cardiovascular disease is the leading
cause of death for both men and women
in the United States. People primarily
take statins to reduce high levels of “bad”
LDL cholesterol because excess LDL
cholesterol contributes to the buildup
of plaques in artery walls.
For some patients taking statins, doctors also monitor triglycerides because
high levels of the fats can increase the
risk of heart attack and stroke. Conditions like obesity and diabetes can lead
to high triglyceride levels.
Vascepa has already been approved by
the U.S. Food and Drug Administration
to lower triglycerides in people with very
high levels (500 milligrams per deciliter
of blood or higher). In the new Phase III
clinical trial—conducted to gain
approval for the drug’s use in a different
group of people — preventive cardiologist Christie Ballantyne and colleagues
tested whether the drug could help prevent heart attacks and strokes in heart
disease patients and in those with risk
factors like diabetes.
The drop in heart-related health risk
observed in the study is “very encouraging,” says Ballantyne, of Baylor College
of Medicine in Houston. s
strokes, heart failure and an irregular
heartbeat known as atrial fibrillation.
But VITAL, a Phase III clinical trial, is
the largest randomized trial to specifically test whether boosting vitamin D
levels prevents cardiovascular disease.
JoAnn Manson, an epidemiologist
at Brigham and Women’s Hospital and
Harvard Medical School in Boston, and
colleagues followed 25,871 U. S. men ages
50 and older and women ages 55 and
older for up to six years. Participants
were relatively healthy, with no history of cardiovascular disease or cancer,
except non-melanoma skin cancer, at the
start. The trial also included 5,106 black
participants, important because people
with darker skin have lower levels of the
vitamin because pigmentation reduces
production of the vitamin in the skin.
Among people taking vitamin D, 396
had a heart attack or stroke, or died
from cardiovascular disease, compared
with 409 taking a placebo. Differences
were similarly insignificant for cancer:
793 people taking vitamin D were diagnosed with invasive cancers compared
with 824 people taking a placebo.
The results were published online
November 10 in the New England
Journal of Medicine.
Previous trials hinted that vitamin D
falls short in preventing heart disease
and cancer. But those trials were smaller
and used lower doses, and most were
designed to test effects on other health
issues, such as bone strength.
But vitamin D doesn’t appear to help
bone health either. A study in the Nov. 1
Lancet Diabetes & Endocrinology found
no evidence that vitamin D reduces fractures or falls, or improves bone density.
“Low vitamin D in the blood might
just be a marker of someone in a poorer
health state in general,” Michos says. s