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Marine n-3 fatty acids and prevention of cardiovascular disease and cancer (VITAL)
Same VITAL cohort: marine n-3 fatty acids 1 g/day for median 5.3 years did not reduce major cardiovascular events (HR 0.92) or invasive cancer (HR 1.03) versus placebo; secondary total myocardial infarction HR 0.72 (95% CI 0.59–0.90).
Design
- Trial: VITAL — 2×2 factorial; this arm reports marine n-3 fatty acids 1 g/day vs placebo
- Primary end points: major cardiovascular events and invasive cancer
Primary outcomes
- Major CV events: 386 (n-3) vs 419 (placebo); HR 0.92 (95% CI 0.80–1.06; P = 0.24)
- Invasive cancer: 820 vs 797; HR 1.03 (95% CI 0.93–1.13; P = 0.56)
Secondary signals called out in abstract
- Total myocardial infarction: HR 0.72 (95% CI 0.59–0.90)
- Expanded CV composite, stroke, cancer death, all-cause mortality: HRs near 1 with CIs spanning null for several comparisons—read tables before treating as benefits
Evidence hygiene
- Primary prevention US cohort; 1 g/day marine n-3 formulation differs from high-dose purified EPA prescription trials (e.g., REDUCE-IT on
marine-omega-3-supplementation). - Do not merge with vitamin D VITAL row—distinct randomized arms and publications.
Publication
Manson JE, Cook NR, Lee IM, et al. N Engl J Med. 2019 Jan 3;380(1):23-32. PMID 30415637; NCT01169259.
Outcomes
- Primary endpoint major cardiovascular events: HR 0.92 (95% CI 0.80–1.06; P=0.24) for marine n-3 1 g/day vs placebo (VITAL).
- Primary endpoint invasive cancer: HR 1.03 (95% CI 0.93–1.13; P=0.56) vs placebo.
- Secondary endpoint total myocardial infarction: HR 0.72 (95% CI 0.59–0.90) vs placebo—secondary/hypothesis context only.