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Omega-3s Beat Other Cardiac Interventions in Computer Study
10/18/2006
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Computer model suggests that fish fats outdo death-reduction impact of cardiac defibrillators
by Craig Weatherby


You’ve probably heard of “Sim City” (simulated city). This popular entertainment software allows users to construct an imaginary city and change any of the myriad variables affecting its people, economies, and infrastructures, just to see what happens.

Recently, a team led by Thomas E. Kottke M.D. of Regions Hospital in St. Paul, Minnesota used a simpler health-outcomes-focused computer model to test the life-saving impacts of a dietary factor known to reduce the risk of sudden cardiac death (marine omega-3s), versus emergency electronic interventions.

Key Points
  • Computer model places omega-3s above defibrillators as means of preventing sudden cardiac death.
  • Model assumes intake of one gram per day: the amount recommended by the American Heart Association for people diagnosed with cardiovascular disease.
  • Conclusion of overall benefit is not diminished significantly by the fact that dietary omega-3s can be risky for people with implantable cardiac defibrillators (ICDs), who should avoid them.
More than 654,000 Americans died of heart disease in 2004, according to the National Center for Health Statistics: a death toll higher than for all forms of cancer combined (just over 550,000 deaths).

And most of these deaths occurred in the form of sudden cardiac death, which often occur in people never diagnosed with cardiovascular disease.

So it is of great interest that the new, computer-aided analysis suggests that the single most effective way to prevent sudden cardiac death would be an increase in Americans’ average intake of marine omega-3s from fish and fish oil.

Minnesota “Sim City” experiment elevates omega-3 benefits
Dr. Kottke’s team of researchers estimated the effects of various preventive strategies, using a computer-simulated community of 100,000 imaginary people aged 30 to 84 (Kottke T et al 2006).

They entered data to create a “cyber-population” whose heart-health characteristics mirrored those of the real people of Olmsted County, Minnesota, in terms of the numbers of people at various stages of various cardiovascular disease conditions.

The researchers used this imagined population to test the effects of three different scenarios on the rates of sudden cardiac death in the entire cyber-population.

While the computer model found that all three scenarios would reduce the risk of sudden death, consumption of one gram of omega-3 fatty acids per day reduced the death rate nearly twice as much as the second best scenario:
  1. Omega-3s: Deaths were reduced by 6.4 percent if everyone in the imagined cyber-population was assumed to consume one gram omega-3 fatty acids per day (from fish and/or fish oil supplements).

  2. Implantable cardiac defibrillators (ICDs): Deaths were reduced by 3.3 percent if everyone who needed an ICD had one. (Only people in an advanced state of cardiovascular disease were assumed to need an ICD.)

  3. Automated external defibrillators (AEDs): Deaths were reduced by less than one percent (0.8) if AEDs were readily available in homes and public areas. (These devices can restore normal heart rhythms to people suffering sudden cardiac arrest caused by the erratic rhythms called arrhythmias.)
Unsurprisingly, the computer model showed that the rate of sudden cardiac death was reduced the most when all three scenarios were assumed to be in place at once.

Note: This last outcome is not affected much by the recent finding that moderate intake of omega-3s appears to raise the risk of arrhythmias among the small percentage of heart patients with implantable cardiac defibrillators (ICDs). Since these folks are so few in number, an assumption of omega-3 avoidance by people in the imaginary city with ICDs would not have affected the strongly pro-omega-3 outcomes to a significant extent.

As Dr. Kottke’s team concluded, “…raising n-3 [omega-3] fatty acid levels would have about eight times the impact of distributing AEDs and two times the impact of implanting ICDs. Raising n-3 [omega-3] fatty acid levels would also reduce rates of sudden death among the subpopulation that does not qualify for ICDs.”

These useful findings provide an excellent example of the utility of computer-driven medical models in determining the most effective preventive measures, when there is enough good input data from actual human studies to permit credible conclusions. A similar study in people would be far lengthier and costlier, and would present some ethical quandries.

More importantly, they appear to validate the value of dietary omega-3s in preventing sudden cardiac death.


Sources
  • Kottke TE, Wu LA, Brekke LN, Brekke MJ, White RD. Preventing Sudden Death with n-3 (Omega-3) Fatty Acids and Defibrillators. Am J Prev Med. 2006 Oct;31(4):316.
  • Orencia A, Bailey K, Yawn BP, Kottke TE. Effect of gender on long-term outcome of angina pectoris and myocardial infarction/sudden unexpected death, Jama 269 (1993) (18), pp. 2392–2397 May 12.
  • Roger VL, Weston SA, Redfield MM. Trends in heart failure incidence and survival in a community-based population, JAMA 292 (2004) (3), pp. 344–350 Jul 21.
  • Senni M, Tribouilloy CM, Rodeheffer RJ. Congestive heart failure in the community: a study of all incident cases in Olmsted County, Minnesota, in 1991, Circulation 98 (1998) (21), pp. 2282–2289 Nov 24.
  • Russell LB, Milan E, Jagannathan R. Comparison of two surveys of hospitalization: the National Hospital Discharge Survey and the NHANES I Epidemiologic Followup Study, Vital Health Stat 2 (1997) (123).
  • Wilso PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories, Circulation 97 (1998) (18), pp. 1837–1847 May 12.
  • Senni M, Tribouilloy CM, Rodeheffer RJ, et al. Congestive heart failure in the community: trends in incidence and survival in a 10-year period, Arch Intern Med 159 (1999) (1), pp. 29–34 Jan 11.
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