Does having higher levels of EPA in my blood increase my risk of ischemic heart disease?
Eicosapentaenoic acid (EPA) is an omega-3 fatty acid found in fish oil. Some studies suggest it protects the heart, but recent genetic research raises the possibility that higher EPA levels could slightly increase the risk of ischemic heart disease (IHD). This answer looks at what the evidence shows.
What the research says
A 2021 Mendelian randomization study using genetic variants found that higher genetically predicted EPA levels were associated with a small increase in the odds of IHD (odds ratio 1.05, 95% confidence interval 1.00 to 1.10) 1. Another Mendelian randomization study from the same year also reported that genetically predicted EPA was not protective and showed a trend toward increased IHD risk, though the results were not statistically significant 6. These findings contrast with some earlier trials that suggested EPA might reduce heart disease risk in people with high triglycerides 1. However, the evidence is not strong enough to conclude that EPA causes IHD. The studies used genetic markers, which can help rule out confounding, but the effect size is small and the confidence intervals are wide. Other sources in this set do not directly address EPA and IHD risk 2345.
What to ask your doctor
- What do my current EPA and omega-3 levels look like, and should I have them tested?
- Given my personal risk factors for heart disease, would taking EPA supplements be beneficial or harmful?
- Are there other ways to get omega-3s, like eating fish, that might be safer than supplements?
- How do the potential risks of higher EPA levels compare with other heart disease risk factors I have?
This question is drawn from common patient questions about this topic and answered using cited medical research. We do not provide individualized advice.