Key Insights from the REDUCE-IT Trial
In a recent press release from the American College of Cardiology, researchers shared that the cardiovascular benefits observed in the REDUCE-IT trial were strongly correlated with blood EPA levels, not just reductions in triglycerides as previously assumed.
This finding was presented at the 2020 ACC Scientific Session by Dr. Deepak L. Bhatt, executive director of interventional cardiovascular programs at Brigham and Women’s Hospital and professor at Harvard Medical School. According to Dr. Bhatt, while triglyceride and other risk marker changes played a role, achieved EPA blood levels were the primary driver of cardiovascular event reduction with icosapent ethyl (Vascepa).
The Scope of the Study
The REDUCE-IT trial enrolled over 8,000 patients across 11 countries who were at high cardiovascular risk and already on statin therapy. Participants taking high-dose icosapent ethyl experienced a:
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25% reduction in first cardiovascular events
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30% reduction in total cardiovascular events
These included heart attacks, strokes, cardiovascular deaths, coronary procedures, and hospitalizations for unstable angina.
Importantly, the benefit was independent of baseline EPA levels, meaning even those with low EPA at the start experienced significant benefit if high EPA levels were achieved during treatment.
EPA Levels: The Strongest Predictor of Benefit
Dr. Bhatt’s team found that:
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EPA levels increased by 386% from baseline after one year of treatment
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The higher the EPA level, the lower the rates of cardiovascular events, sudden cardiac death, and cardiac arrest
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Patients in the highest third of achieved EPA levels had the greatest cardiovascular benefit
Interestingly, DHA levels decreased slightly, suggesting that the cardiovascular benefit comes specifically from EPA.
Why Prescription-Grade EPA Differs
While the trial’s results are impressive, Dr. Bhatt noted that these benefits are not easily replicated through diet or dietary supplements:
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Achieving equivalent EPA levels through food alone is unrealistic
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Replicating REDUCE-IT levels with fish oil supplements would require 20–30 capsules daily, which is impractical and may include unwanted ingredients like DHA
This explains why icosapent ethyl is a prescription-only product, specifically approved by the FDA in December 2019 for reducing cardiovascular risk in adults with:
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Triglycerides ≥150 mg/dL
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Existing cardiovascular disease or diabetes with multiple risk factors
Dr. Bhatt estimated that over 12 million Americans could benefit from this therapy.
What If You're Not Eligible for Prescription Omega-3?
While Vascepa is not appropriate for everyone, dietary omega-3s and high-quality supplements still offer measurable benefits. For individuals who don’t qualify for prescription EPA, maintaining heart health through omega-3 intake is still essential.
The best way to start is by testing your Omega-3 Index—a simple blood test that reflects your EPA and DHA status. Based on this value, you can determine how much omega-3 you need to reach the target protective range of 8%–12%.
Estimating Your Omega-3 Needs
A paper published by OmegaQuant researchers Drs. William Harris and Kristina Harris Jackson offers practical dosage guidance:
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To raise your Omega-3 Index to 8% within 3–4 months, most people need 1–2 grams of EPA and DHA daily
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Dosage varies by starting Omega-3 Index and whether you're using a triglyceride or ethyl ester-based supplement
This research also emphasizes that low-dose interventions often fail to show benefit, not because omega-3s don’t work—but because the dose is insufficient to shift blood levels meaningfully.
The Role of the Omega-3 Index
The Omega-3 Index is widely used in major studies like the Framingham Heart Study and the Women’s Health Initiative. With more than 200 peer-reviewed studies supporting its validity, the Omega-3 Index is emerging as a recognized risk factor for cardiovascular disease, comparable in importance to LDL cholesterol.
Testing and targeting your Omega-3 Index is a personalized approach to cardiovascular prevention—one that lets you measure, modify, and monitor your progress based on objective data.
Ballstad Omega-3, with its high concentration of EPA and DHA, is a reliable supplement option for individuals aiming to reach cardioprotective omega-3 levels without the need for prescription medication.
EPA Levels Matter Most
The REDUCE-IT trial revealed a powerful truth: your blood EPA levels matter more than your triglycerides when it comes to cardiovascular risk reduction. While prescription-grade EPA has a unique role in high-risk patients, omega-3 intake from food and supplements remains critical for broader population health.
Whether you’re managing cardiovascular risk, supporting brain health, or aiming to age well, start by knowing your numbers. With the Omega-3 Index as your guide, and a trusted product like Ballstad Omega-3 as your ally, you're equipped to take informed, effective steps toward long-term heart health.
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Credit: OmegaQuant Website
