The Virginia Circulation Research Center is providing a substance found in fish oil known as EPA (eicosapentaenoic acid) through the VCIRC.ORG web portal as part of its fundraising efforts. VCIRC.ORG is a public charity granted tax-exempt status by the US IRS under section 501(c)(3) that is dedicated to the development of the biomedical science community in Roanoke, as well as the study of cardiovascular molecular biology. This fundraising activity might be considered to be a heart-healthy, internet-based version of a bake sale, without the cholesterol or the sugar or the saturated fat!

Low doses of generic fish oil capsules don’t contain enough EPA to make a difference in the management of heart disease, as proven in several clinical trials. Unrefined fish oil preparations can also contain mercury, cadmium, and other environmental contaminants. There are some highly purified and potent prescription fish oil products available like LOVAZA and VASCEPA that are well tolerated, but very expensive. LOVAZA contains approximately 465 mg of EPA and 375 mg of DHA per capsule. VASCEPA contains either 500 mg or 1000 mg of EPA. The EPA content is what counts. After my review of the subject, I am recommending CARLSON ELITE EPA Gems to patients with a history of atherosclerotic cardiovascular disease and patients that have a history of diabetes with other risk factors for cardiovascular disease. Please check with your health care provider before beginning EPA therapy. Side effects, although rare, may appear.

CARLSON ELITE EPA GEMS are soft capsules in bottles (120 count) that contain 1,000 mg of EPA (eicosapentaenoic acid) per capsule. Two taken twice a day would be considered roughly equivalent to the high dose used in the REDUCE-IT study performed in the USA and 10 countries. The REDUCE-IT trial led to a 25% reduction in major coronary events in patients with a history of atherosclerotic cardiovascular disease and in diabetics with risk factors for atherosclerosis. VASCEPA contains 1,000 mg of EPA per capsule, and Carlson’s EPA is similar, but may be not entirely identical. Remember to continue to take a statin if your provider recommends it and you are able, because EPA will not significantly change your bad cholesterol levels. EPA seems to work through another mechanism.

John F. Schmedtje Jr., MD, FACC

LOVAZA is a registered trademark of GlaxoSmithKline.
VASCEPA is a registered trademark of AMARIN Corp.
REDUCE-IT: New England Journal of Medicine 2019; Volume 380, pages 11-22.