Omega-3 fatty acids may prevent more sudden
deaths than automated external defibrillators
in homes and public places or implanted defibrillators,
according to the results of a new study.
Researchers compared these preventive strategies
in a computer-simulated community of 100,000
people that resembled the population of Olmsted
County, Minn., in 2000.
By raising omega-3 fatty acids levels among
the cyber-Olmsted citizens, Thomas Kottke,
M.D., and colleagues were able to lower overall
death rates in the simulated population by
6.4 percent.
By contrast, automated external defibrillators
or AEDs reduced death rates by 0.8 percent,
and implanted defibrillators (ICDs) reduced
deaths by 3.3 percent, found the researchers
led by Kottke, a cardiologist at the Heart
Center, Regions Hospital in St. Paul, Minn.
People can raise their omega-3 levels by
eating fish or taking supplements.
The study, published in the October issue
of the American Journal of Preventive Medicine,
showed that raising omega-3 fatty acids "would
have about eight times the impact of distributing
AEDs and two times the impact of implanting
ICDs," Kottke said.
Three-quarters of the reduction in deaths
from increased omega-3 fatty acid levels would
come from raising omega-3s among the healthy
portion of the population, according to the
researchers.
Although previous studies have shown that
omega-3 fatty acids and defibrillators can
prevent sudden cardiac deaths, it is difficult
to compare their effectiveness across a population,
the researchers say.
For instance, people who suffer from a cardiac
condition can be prescribed a series of different
treatments and may follow their doctors'
orders to different degrees. To keep these
types of variables under control, Kottke and
colleagues developed the computer simulation,
which combined realistic data on patient health
and treatments with unrealistic conditions
such as 100 percent patient compliance with
doctors' prescriptions.
Raising blood levels of omega-3 fatty acids
in individuals after a cardiac event such
as a heart attack could save 58 lives a year,
according to the simulation's predictions.
Only seven lives per year were saved by AEDs,
while implantable defibrillators prevented
30 deaths each year under simulation conditions.
"Despite the fact that AEDs do save
lives, they are unlikely to ever have a substantial
impact on rates of sudden death," Kottke
said, explaining that a whole chain of events
from speedy application of the device to surviving
in the hospital has to occur to save a person
with an AED.
Other studies suggest that proper AED training
may also make a difference in how safely the
devices would be used if they were as widely
available as in the simulation. A recent study
by Mary Ann Peberdy, M.D., of the Virginia
Commonwealth University Health System and
colleagues found very few harmful incidents
related to AED use by training lay volunteers.
"There were no inappropriate shocks
and no failures to shock when indicated,"
Peberdy said of the study, which included
more than a thousand public facilities and
residences in the United States and Canada.
"AEDs have an exceptionally high safety
profile when used by trained lay responders,"
she added.
Kottke and colleagues also note the comparative
costs of omega-3 versus defibrillator treatment.
For example, a population similar to the simulation
could raise their omega-3 levels with daily
supplements for $5.8 million a year.
"If however, a large proportion of the
community ate fish high in omega-3 content
rather than other meat, much of the cost would
be offset," Kottke said.
Equipping every household in a similar population
with an AED would cost $201 million, the researchers
estimate. However, their analysis shows that
equipping first responders such as paramedics
and firefighters with AEDs for a comparable
population would be "relatively inexpensive,"
costing only $195,000, Kottke said.
The study was supported by the Centers for
Disease Control and Prevention and the Association
for Prevention Teaching and Research.
Kottke, TE, et al. (2006) Preventing sudden
death with n-3 (omega-3) fatty acids and defibrillators.
Am J Prev Med 31(4), 2006.
