Everyone knows omega-3s are “good for your heart,” but how good are they, really? My name is Dr. Paul Hrkal, and I want to give you a quick, research-based review of omega-3 supplementation and cardiovascular disease.

A large 2019 meta-analysis set out to answer two key questions:

• Do omega-3s (EPA + DHA) reduce cardiovascular risk?
• Does the dosage change the size of the benefit?

Understanding the Big Picture: Risk Reduction Across Key Outcomes

In the analysis, researchers compared omega-3 supplementation to placebo across multiple cardiovascular outcomes, including:

• Overall cardiovascular disease (CVD) events
• Heart attacks (myocardial infarctions)
• Coronary heart disease (CHD) events
• Fatal heart attacks
• CHD mortality

A helpful way to interpret these findings is to understand that a result “below 1” in relative risk means risk is reduced. Across the major categories, the results generally favored omega-3 supplementation, meaning participants taking omega-3s tended to see a lower risk than those taking placebo.

What the Meta-Analysis Found: The Real Numbers

1) Fatal Heart Attacks Were Reduced the Most

The most striking finding was a 35% relative risk reduction in fatal heart attacks among those supplementing with omega-3s (EPA + DHA). This is one of the “big outcomes” people care about most: not just having a cardiovascular event, but reducing the risk of dying from one.

2) Lower Risk of Heart Attacks and CHD Events

Omega-3 supplementation was also associated with meaningful reductions in non-fatal events:

• 13% lower risk of heart attacks
• 10% lower risk of coronary heart disease events

3) CHD Mortality Also Improved

In addition to reducing fatal heart attacks, the analysis found a 9% relative risk reduction in coronary heart disease mortality.

4) Overall CVD Events: Small Reduction, Not Statistically Significant

For overall cardiovascular disease events, the risk reduction was about 5%. In this study, that specific finding was not statistically significant, meaning it did not meet the strict threshold researchers use to rule out chance. However, the overall trend still favoured the benefit.

Dose Matters: The Benefits Were Dose-Dependent

One of the most practical takeaways from this research is that omega-3s appear to have dose-dependent benefits for cardiovascular protection. In other words, higher doses were associated with stronger effects.

Here is the key point the researchers highlighted:

• Each additional gram of combined EPA + DHA was associated with about a 9% relative risk reduction in heart attack incidence.

This is why dosage matters so much. Many people take “a fish oil” and assume they are covered, but the research suggests that the amount of EPA and DHA you actually consume is what drives results.

What to Look for on a Label: EPA + DHA (Not Just “Fish Oil”)

When choosing an omega-3 supplement, the most important thing is to look for the specific amounts of:

• EPA (eicosapentaenoic acid)
• DHA (docosahexaenoic acid)

You want to add EPA + DHA together to understand how much “active omega-3” you are actually getting. Many products (especially general low-dose options commonly found in big-box retailers) may not provide enough EPA + DHA to match the dosages used in clinical trials.

High-Level Summary of the Findings

• 35% reduction in risk of fatal heart attack with omega-3 supplementation (EPA + DHA).
• 13% lower risk of heart attacks.
• 10% lower risk of coronary heart disease events.
• 9% reduction in coronary heart disease mortality.
• Dose matters: each additional gram of EPA + DHA was linked to a 9% relative risk reduction in heart attack incidence.

Calls to Action: How to Apply This

1) Choose Omega-3s With Sufficient EPA + DHA Content

If you are aiming for clinically meaningful benefits, consider products that provide roughly 1 gram (1,000 mg) of combined EPA + DHA per serving as a practical benchmark, because that is where many studies begin to show clearer effects.

2) Consider Higher Dosages if Heart Health Is a Concern

For those with higher cardiovascular risk, research trends suggest stronger effects at higher intakes. Some protocols use doses up to 4 grams per day, but this should be done under professional supervision, especially if you are on medications or have a medical condition.

3) Prioritize Heart-Targeted Omega-3 Formulas

If your goal is cardiovascular prevention and support, do not rely on a generic “fish oil” label alone. Choose a product that clearly lists EPA and DHA amounts, and consider heart-targeted formulas that deliver meaningful levels of these omega-3s.

Final Takeaway

Overall, the research discussed here suggests that omega-3 supplementation (EPA + DHA) has a positive impact on cardiovascular outcomes, especially the outcomes that matter most: reducing heart attacks and lowering the risk of fatal events. And importantly, the benefits appear to improve as the EPA + DHA dosage increases.

Hopefully this helps streamline your decision-making so your supplementation is more focused, evidence-informed, and meaningful.