Lipid-lowering drugs and essential omega-6 and omega-3 fatty acids in patients with coronary heart disease

Nutr Metab Cardiovasc Dis. 2005 Feb;15(1):36-41. doi: 10.1016/j.numecd.2004.09.001.


Background and aim: There are only little data about the effects of lipid-lowering drugs (LLDs) on the metabolism of essential n-6 and n-3 fatty acids in patients with established coronary heart disease (CHD).

Methods and results: Male patients with CHD and high cholesterol levels (>6.2 mmol/L) were randomized (double-blind protocol) to receive either simvastatin 20mg (S) or fenofibrate 200mg daily (F) for 3 months. Dietary habits and plasma fatty acids were not different in the two groups at baseline. After treatment, there were significant changes in both the groups for the main n-6 fatty acids, with an increase in arachidonate (from 6.5+/-1.7% of total fatty acids to 7.5+/-2.1, p<0.001 in S and from 6.2+/-1.4 to 6.8+/-1.4, p<0.005 in F) and a decrease in linoleate (from 26.9+/-3.9 to 24.2+/-3.6, p<0.001, and from 27.8+/-3.4 to 26.1+/-4.2, p<0.05, in S and F, respectively). In addition, there was a decrease in two major n-3 fatty acids (alpha-linolenate and docosahexanoate, both p<0.05), but only in F.

Conclusions: For the first time in a double-blind randomized study in CHD patients, we report that LLDs significantly alter the metabolism of essential fatty acids that are critically important for the pathogenesis and prevention of CHD. Further studies are urgently needed to examine the effects of higher dosages of statins (as currently proposed to reduce more cholesterol) on these essential fatty acids in the clinical setting and the crucial questions of whether specific dietary intervention (combining low intake of n-6 fatty acids and high intake of n-3 fatty acids) may improve the effectiveness of these drugs.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Analysis of Variance
  • Coronary Disease / blood
  • Coronary Disease / drug therapy
  • Coronary Disease / prevention & control*
  • Diet, Mediterranean
  • Double-Blind Method
  • Drug Synergism
  • Fatty Acids, Omega-3 / administration & dosage
  • Fatty Acids, Omega-3 / blood
  • Fatty Acids, Omega-3 / metabolism*
  • Fatty Acids, Omega-6 / administration & dosage
  • Fatty Acids, Omega-6 / blood
  • Fatty Acids, Omega-6 / metabolism*
  • Fenofibrate / pharmacology
  • Fenofibrate / therapeutic use
  • Humans
  • Hypolipidemic Agents / pharmacology*
  • Hypolipidemic Agents / therapeutic use
  • Male
  • Middle Aged
  • Simvastatin / pharmacology
  • Simvastatin / therapeutic use


  • Fatty Acids, Omega-3
  • Fatty Acids, Omega-6
  • Hypolipidemic Agents
  • Simvastatin
  • Fenofibrate