CAN OMEGA-3 FATTY ACID PREVENTS HEART ATTACK?

Yes—but the answer is more nuanced than simply “omega-3 prevents heart attacks.”

What the evidence shows

Eating fish and having adequate omega-3 intake is associated with cardiovascular benefits, but ordinary fish-oil supplements do not consistently prevent a first heart attack in healthy people. Large randomized trials have generally found little or no reduction in major cardiovascular events from standard-dose EPA+DHA supplements. (professional.heart.org)

There is, however, an important exception:

High-dose prescription EPA (icosapent ethyl) has been shown to reduce cardiovascular events in a specific high-risk population—people with cardiovascular disease or diabetes plus other risk factors, already taking statins and having elevated triglycerides. In REDUCE-IT, 4 g/day reduced the composite risk of cardiovascular death, nonfatal heart attack, stroke, revascularization, or unstable angina by 25%. (New England Journal of Medicine)

So, can omega-3 protect against a heart attack?

Omega-3 approach	Evidence for heart-attack prevention
Eating fatty fish regularly	Yes, as part of a heart-healthy diet
Standard fish-oil supplement	Not reliably proven to prevent heart attacks
EPA + DHA supplement	May have cardiovascular benefits, but prevention evidence is inconsistent
Prescription EPA (icosapent ethyl) 4 g/day	Yes, in selected high-risk patients
Replacing heart medications with omega-3	No

There is also an important distinction between preventing a first heart attack and preventing another heart attack after someone already has coronary disease. Earlier studies suggested benefits after myocardial infarction, but more recent trials have produced mixed results. (professional.heart.org)

Why might omega-3 help the heart?

EPA and DHA can potentially:

↓ triglycerides → ↓ inflammation → improve endothelial function → modestly lower blood pressure → reduce platelet activity → potentially reduce cardiovascular risk

However, the cardiovascular effect is not simply because omega-3 “cleans out” cholesterol or removes artery plaques.

For someone in their 60s, the most important proven ways to prevent a heart attack remain controlling LDL cholesterol, blood pressure, diabetes, smoking, weight, exercise and diet. Omega-3 can be one component of that strategy, but it shouldn't substitute for those measures.