[devonEnlis]

Study linked was not the biggest cardiovascular health news of today--

This was: https://www.nejm.org/doi/full/10.1056/NEJMoa1812792

A single purified component of fish oil - EPA, did lead to a 25% relative risk reduction on top of statin treatment. This is a huge result with off the charts p values.

[dmix]

Importantly the results were only positive for those:

> Among patients with elevated triglyceride levels

Much like low dose aspirin its possible this is a bad idea for the average person unless you are already showing signs of heart disease.

[koboll]

https://examine.com/supplements/fish-oil/#hem-triglycerides

The effect is stronger in individuals with elevated triglyceride levels, but it seems to lower triglycerides in those with more normal levels as well.

[agsdfgsd]

How is low dose aspirin bad for the average person? It is an anti-inflammatory, and inflammation is a leading theory of potential disease causation for a number of diseases. Daily low dose aspirin is associated with a significantly lower all-cause mortality in average people.

[loeg]

> How is low dose aspirin bad for the average person?

There's a small dollar cost, and there's this whole section: https://en.wikipedia.org/wiki/Aspirin#Adverse_effects

[agsdfgsd]

Nothing there suggests it is bad for the average person. The average person will lower their chances of dying by taking daily low dose aspirin. The average person does not have a sensitivity to aspirin, and the side effects of high dose aspirin don't apply.

[majkinetor]

Aspirin has detrimental effects on stomach, thats how. Ibuprofen was created because of that.

Think 1 teaspoon of blood per day that you bleed from stomach.

Vitamin C can prevent some of that but it still exists.

[agsdfgsd]

It has such effects only in a small portion of people, and only in high doses. That is not a reason for average people to avoid a daily low dose, which has a direct reduction in all cause mortality.

[raspasov]

Yes, the fraud product from a one-product-wonder public company Amarin (NASDAQ: AMRN).

(see my comment below).

[devonEnlis]

"fraud product" - Do you mean the product that has been FDA approved for 6 years? Is the FDA "in" on the fraud? Is the New England Journal of Medicine in too?

Does having one product (that sold $xxx mil last year) make a bad company? Or one that put all of it's chips into this long term outcomes study? (which has now paid off)

Why do you care so strongly about this?

[coldtea]

>"fraud product" - Do you mean the product that has been FDA approved for 6 years? Is the FDA "in" on the fraud?

No, but something can be both FDA approved and fraud, e.g. snake oil. It just can't be particularly dangerous.

>Why do you care so strongly about this?

Wasn't you who devoted 4-5 arguments to a single comment the parent made? Why add this pop-psychology facile dismissal? What does "care so strongly" even means as an argument?

[devonEnlis]

Trying to understand the commenter's motivations. This product has reduced cardiovascular death - if his fraud conspiracy theory convinces appropriate patients not to take it, it could literally kill people.

[coldtea]

First time hearing about the product, but looking at the facts, the parent seems to be right. It's more snakeoil than product. Your argument was that FDA approved it, but here's the actual story:

"On 10/16/2013 after FDA's ADCOM panel had voted 9-2 against recommending to expand Vascepa's label for treatment of cardiovascular disease, shares dropped over 60%"

"In March 2016, after losing a court case, the FDA agreed to allow some off-label marketing"

So, it's not like FDA approved it as a drug for cardiovascular disease. They overwhelmingly rejected it as so, and then were forced to allow it to market it self off-label as such (for "free speech" purposes, as opposed for medical reality).

[raspasov]

No better than regular fish oil but costs hundreds of dollars a month.

A way to scam money out of Medicare.

Using mineral oil in the study to make their product look superior.

I'm not the only one to share those concerns: https://www.forbes.com/sites/matthewherper/2018/11/10/fish-o...

The biomarkers of patients in the PLACEBO group decreased significantly (up to 30%). Why?

"But what seriously bothered five of the six cardiologists I spoke to was that the mineral oil had not behaved as a placebo at all. In other studies of cardiovascular drugs, blood test results on placebo do not budge. That’s not what happened here. Patients who received mineral oil saw their levels of low-density lipoprotein, the bad cholesterol, increase 10% to 84 milligrams per deciliter, 6% more than in the Vascepa group, according to the New England Journal of Medicine paper. What’s more, other blood test results used by cardiologists also went in the wrong direction. These changes were included in a supplement to the scientific paper, but not in the study itself. Levels of c-reactive protein, a measure of inflammation that is used to help calculate heart risk by some doctors, increased from 2.1 milligrams per liter to 2.8 milligrams per liter, a 30% increase. Could the placebo be causing some heart problems or strokes, making Vascepa look better than it really is?"

Shame on NPR for the sloppy reporting.

[agsdfgsd]

But since statins increase deaths from cardiovascular disease, it is very possible that EPA is only protective against the damage of statins, rather than being beneficial in general.