Elevated cholesterol and triglyceride levels are a risk factor for heart disease, high blood pressure, chronic kidney disease and circulatory problems. Statins and fish oils are both used to reduce the risk of cardiovascular events such as heart attack and stroke. However, these products lower risk and improve heart health by two different pathways. Fish oil is primarily used to lower triglyceride levels, while statins are used to reduce cholesterol levels. Both have demonstrated the ability to reduce atherosclerotic problems including artery hardening and blockage.
Fish Oil Mechanism of Action
Fish oils contain the omega 3's, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), which lower triglycerides levels and reduce the risk of death from heart attacks, abnormal heart rhythms and strokes in people with cardiovascular disease. Similar to statin medications, fish oils also slow the buildup of atherosclerotic plaques by decreasing platelet aggregation and increasing the breakdown of blood clots. EPA and DHA have been shown to reduce resting heart rate, decrease blood pressure and prevent secondary heart attacks.
Fish Oil Supplements
The most beneficial fish oil supplement will contain an appropriate 50/50 mixture of DHA and EPA. The amount of total omega-3 will vary depending on an individual's health and presence or absence of certain disease states. The American Heart Association (AHA) recommends 1,000 mg of DHA and EPA daily for people with known heart disease and 2,000 to 4,000 mg DHA and EPA daily for high triglyceride levels. The US Food and Drug Administration (FDA) has labeled 3,000 mg or below of DHA and EPA as the "generally recognized as safe" cut off. Larger doses should only be consumed under the supervision of a physician.
Fish Oil Side Effects
High doses of fish oils may act as anti-coagulants and thin blood to unsafe levels. This can increase an individual's risk of excessive bleeding or hemorrhagic stroke. Gastrointestinal upset including diarrhea, belching, abdominal bloating, heartburn and abdominal pain have been reported with fish oil supplements. One of the most common side effects is a fishy aftertaste; however, this can be reduced if supplements are consumed with meals. Rare side effects include increased low density lipoprotein levels (bad cholesterol), mild elevation in liver function and skin rashes. In order to reduce negative side effects, it is advised to start with low doses of supplements and gradually increase to the recommended dose.
Statin Mechanism of Action
Unlike fish oils, statins such as Lipitor, Crestor and Zocor focus on cholesterol not triglyceride reduction. This class of medication reduces the production of cholesterol in the liver by blocking the enzyme, HMG-CoA reductase, which is responsible for making cholesterol. Similar to fish oils, the ultimate goal of statins is to prevent and assist removal of plaque build up in arteries that can cause angina, heart attack, stroke and death. High cholesterol levels are not a requirement to be prescribed a statin medication.
Statin Side Effects
The most common side effects experienced by consumers on statin medications include headache, constipation, diarrhea, nausea, vomiting, rash, muscle pain and weakness. Serious and rare side effects include liver failure and muscle damage known as rhabdomyolysis. The risk of side effects are increased when statins are used in combination with other drugs that lead to the build-up of toxic levels of statins in the body and blood stream.
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