In the prevention and treatment of
cardiovascular disease, in addition to the already proven effective treatment of
dyslipidemia,
hypertension and
diabetes mellitus, omega-3
polyunsaturated fatty acids (n-3 PUFAs) are considered as substances with additive effects on cardiovascular health. N-3 PUFAs combine their indirect effects on metabolic, inflammatory and thrombogenic parameters with direct effects on the cellular level.
Eicosapentaenoic acid (EPA) seems to be more efficient than
docosahexaenoic acid (DHA) in the favorable mitigation of
atherothrombosis due to its specific molecular properties. The inferred mechanism is a more favorable effect on the cell membrane. In addition, the anti-fibrotic effects of
n-3 PUFA were described, with potential impacts on
heart failure with a preserved ejection fraction. Furthermore,
n-3 PUFA can modify
ion channels, with a favorable impact on arrhythmias. However, despite recent evidence in the prevention of
cardiovascular disease by a relatively high dose of
icosapent ethyl (EPA derivative), there is still a paucity of data describing the exact mechanisms of n-3 PUFAs, including the role of their particular metabolites. The purpose of this review is to discuss the effects of n-3 PUFAs at several levels of the cardiovascular system, including controversies.