Heart Patients to be Prescribed Fish Oil

New guidelines issued by the National Institute for Health and Clinical Excellence (NICE) advice doctors to prescribe oily fish or omega-3 fatty acid supplements to heart attack patients. NICE believes risk of further heart attacks can be effectively reduced by such measures.

This is the second set of guidelines issued by NICE, an update on the previous set issued six years ago. However this is the first time the institute has recommended any lifestyle changes. All earlier guidelines for preventing heart attacks covered only treatment with drugs.

The newly included lifestyle section in the guidelines says doctors should advise patients to give up smoking, lead a physically active life (at least 20-30 minutes of activity every day), and stick to a Mediterranean-style diet.

Professor Gene Feder, Chair of the Guideline Development Group said, “The growing evidence that cardiac rehabilitation and specific lifestyle changes reduces the risk of second heart attacks, as well as improving quality of life, is not widely recognized.”

In his opinion, drugs do make an enormous difference in patients who have already had a heart attack; however new study evidence has confirmed that lifestyle changes can play an important role too. Several studies have also found that eating more oily fish can improve post heart attack survival rates.

Under the new guidelines, patients who have had a heart attack in the last three months are advised to eat more oily fish. Doctors may also recommend certain preparations of omega-3 fatty acids as an alternative.

The new guidelines have been welcomed by patient representatives who believe they could have a major impact. John Walsh, a patient representative on the Guideline Development Group said, “There is really a lot of good advice in [the report] that we must ensure gets to patients.” In his opinion, there is good evidence that patients can avoid secondary heart attacks by changing their lifestyle. “The changes that the average person needs to make are really quite small,” he said.

“In my case for example, I’ve decided that I’m not going to choose to live without cheese, but what I do now is eat very much less of it. I’m quite sure that from the patients’ point of view, if we can get this information into their hands and their minds and into their hearts, there will be a big health gain in this area,” he added.

Professor Mayur Lakhani, Chairman of the Royal College of General Practitioners said, “Having a heart attack used to be a life sentence for patients; now it is possible for most patients to lead healthy and fulfilling lives. This requires a high standard of modern medical care and for patients to follow lifestyle advice.”

Research has also found that omacor – a type of omega-3 supplement – can cut the risk of a heart patient suddenly dying by up to 45%. Omacor is the only omega-3 supplement currently licensed for post-heart attack treatment. However with nearly 260,000 people having a first heart attack every year in the UK, and a fifth of those being intolerant to oily fish, the cost to the NHS might be very high. NICE estimates the cost at nearly £7million in the very first year. In such a scenario, the new recommendations from NICE can save the NHS a lot of money.

NICE RECOMMENDATIONS
At least two to four portions of oily fish a week for patients or supplements for up to four years if the patients can’t eat oily fish
Only patients who have had a heart attack in the preceding three months should be prescribed supplements.

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