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n-3 fatty acids and cardiovascular disease. Breslow JL. Am J Clin Nutr. 2006 Jun;83(6 Suppl):1477S-1482S. Review. PMID: 16841857 The results of prospective cohort studies indicate that consuming fish or fish oil containing the n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) is associated with decreased cardiovascular death, whereas consumption of the vegetable oil-derived n-3 fatty acid {alpha}-linolenic acid is not as effective. Randomized control trials (RCTs) in the context of secondary prevention also indicate that the consumption of EPA plus DHA is protective at doses 3 g/d, EPA plus DHA can improve cardiovascular disease risk factors, including decreasing plasma triacylglycerols, blood pressure, platelet aggregation, and inflammation, while improving vascular reactivity. Mainly on the basis of the results of RCTs, the American Heart Association recommends that everyone eat oily fish twice per week and that those with coronary heart disease eat 1 g/d of EPA plus DHA from oily fish or supplements. Directions for future research include 1) RCTs to confirm the initial trials showing that EPA plus DHA decreases cardiovascular death and additional studies to determine whether this effect is due to EPA, DHA, or the combination; the dosage of the effective components; and whether the mechanism of action in humans is prevention of fatal arrhythmias. 2) Clinical studies to determine whether the reduction in cardiovascular disease risk factors is due to EPA, DHA, or the combination and the dosage of the effective components. 3) Clinical studies to determine whether vegetable oil-derived {alpha}-linolenic acid added to a diet enriched in n-6 fatty acids can effectively substitute for fish oil-derived EPA plus DHA.

Serum omega-3 fatty acids are associated with variation in mood, personality and behavior in hypercholesterolemic community volunteers. Conklin SM, Harris JI, Manuck SB, Yao JK, Hibbeln JR, Muldoon MF. Psychiatry Res. 2007 Jul 30;152(1):1-10. Epub 2007 Mar 23.PMID: 17383013

Alpha-linolenic acid and risk of nonfatal acute myocardial infarction. Campos H, Baylin A, Willett WC. Circulation. 2008 Jul 22;118(4):339-45. Epub 2008 Jul 7. Erratum in: Circulation. 2008 Sep 16;118(12):e492. PMID: 18606916 doi: 10.1161/CIRCULATIONAHA.107.762419 Conclusions - Consumption of vegetable oils rich in {alpha}-linolenic acid could confer important cardiovascular protection. The apparent protective effect of {alpha}-linolenic acid is most evident among subjects with low intakes.

Relationship of dietary linoleic acid to blood pressure. The International Study of Macro-Micronutrients and Blood Pressure Study [corrected] Miura K, Stamler J, Nakagawa H, Elliott P, Ueshima H, Chan Q, Brown IJ, Tzoulaki I, Saitoh S, Dyer AR, Daviglus ML, Kesteloot H, Okayama A, Curb JD, Rodriguez BL, Elmer PJ, Steffen LM, Robertson C, Zhao L; International Study of Macro-Micronutrients and Blood Pressure Research Group. Hypertension. 2008 Aug;52(2):408-14. Epub 2008 Jul 7. Erratum in: Hypertension. 2008 Sep;52(3):e29. PMID: 18606902 doi: 10.1161/HYPERTENSIONAHA.108.112383 Dietary linoleic acid intake may contribute to prevention and control of adverse blood pressure levels in general populations

Cardiovascular risk and alpha-linolenic acid: can Costa Rica clarify? Harris WS. Circulation. 2008 Jul 22;118(4):323-4. Epub 2008 Jul 7. Review. PMID: 18606912 doi: 10.1161/CIRCULATIONAHA.108.791467

Types of dietary fat and risk of coronary heart disease: a critical review. Hu FB, Manson JE, Willett WC. J Am Coll Nutr. 2001 Feb;20(1):5-19. Review. PMID: 11293467