People who eat more fish generally have a lower risk of CAD and death due to heart disease. A large clinical trial, JELIS, examined the effects of EPA on CAD in patients with high cholesterol levels. Some of these patients on statin drugs (to control cholesterol levels in the blood) but with no evidence of CAD were administered EPA, while others were not. The scientists investigated relationships between the occurrence of CAD, the number of CAD risk factors (obesity, hypercholesterolemia, high TG or low HDL-C, diabetes and hypertension) and EPA treatment. In the higher risk group (TG â‰¥150 mg/dl; HDL-C < 40 mg/dl), EPA treatment prevented the risk of CAD by 53%. In a meta-analysis of studies of 222,364 individuals, the risk of death due to CHD gradually declined in individuals who ate fish one to three times per month, once per week, two to four times per week, or more than four times per week than in those who ate fish less than once per month. The GISSI-Prevenzione Trial showed that the beneficial effects of fish consumption are related to intake of n-3 fatty acids, which have been shown in trials of supplements to decrease subsequent cardiovascular disease.
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