A small-scale pilot study has linked omega-3 fatty acid supplementation to improved social function and reduced cognitive depression in patients with combined chronic heart failure (CHF) and major depressive disorder.
The research, led by Wei Jiang, MD, and published in JACC: Heart Failure this month, randomized 108 CHF patients with major depression 1:1:1 to 2 grams of 400/200 eicosapentaenoic acid (EPA)/docosahexaenoic acid (DHA) fish oil daily, 2 grams of a pure EPA oil daily or a placebo. The study stemmed from the SADHART trial, which found low levels of EPA and DHA were associated with worse outcomes in depressed heart failure patients.
American College of Cardiology guidelines call for screening in all cardiac patients who are hospitalized—something JACC: Heart Failure editor-in-chief Christopher M. O’Connor, MD, said underlines the importance of depression as a cardiovascular risk factor.
“One of the important findings, which was uncovered many years ago and has stood the test of time, is that depression, like many other conventional risk factors such as hypertension, hypercholesterolemia and smoking, poses a two- to three-fold increased risk of major morbidity and mortality in cardiac patients, particularly heart failure patients,” he wrote in a commentary tied to Jiang et al.’s study.
O’Connor said cognitive behavioral therapy and pharmacologic therapies using selective serotonin reuptake inhibitors can reduce depressive symptoms, but "these strategies are labor-intensive and often not practical in the broad patient population of heart failure.”
In their research, Jiang and colleagues found all omega-3 variables were significantly elevated in patients randomized to one of the two fish oil treatments. Patients treated with the placebo reported little change, and per-protocol exploratory analyses found scores of social functioning improved notably in those treated with omega-3s.
Patients taking fish oil supplements were also more likely to experience a reduction in their depressive symptoms.
O’Connor said the study—also known as the OCEAN trial—highlights the effort physicians are making to understand and better treat depression in heart failure patients. Still, he said it’s a challenging area of research “with few gains, other than the importance of heightened awareness.”
“The findings are encouraging, but not enough to stand alone,” he said. “Thus, larger-scale studies are needed to evaluate strategies of supplementation, which in previous analyses have been shown to improve depressive symptoms and may be particularly effective in the heart failure population, which appears to be resistant to many conventional therapies for depression.”
After graduating from Indiana University-Bloomington with a bachelor’s in journalism, Anicka joined TriMed’s Chicago team in 2017 covering cardiology. Close to her heart is long-form journalism, Pilot G-2 pens, dark chocolate and her dog Harper Lee.