Aspirin and omega-3 polyunsaturated fatty acid use and their interaction in cardiovascular diseases and colorectal adenomas

Abstract

Aspirin (acetylsalicylic acid, ASA) is inexpensive and is established in preventing cardiovascular disease (CVD) and colorectal adenomas. Omega-3 (n3) polyunsaturated fatty acids (PUFA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have also shown benefit in preventing CVD. The combination could be an effective preventative measure in patients with such diseases. ASA and n3 PUFA reduced the risk of CVD in ASA resistant or diabetic patients. EPA and DHA deficient patients also benefited the most from n3 PUFA supplementation. Synergistic effects between ASA and EPA and DHA are “V-shaped” such that optimal ASA efficacy is dependent on EPA and DHA concentrations in blood. In colorectal adenomas, ASA (300 mg/d) and EPA reduced adenoma burden in a location and subtype specific manner. Low doses of ASA (75-100 mg/d) were used in CVD prevention; however ultra-low doses (30 mg/d) can also reduce thrombosis. EPA to DHA ratio is also important with regards to efficacy. DHA is more effective in reducing blood pressure and modulating systemic inflammation, however high dose EPA can lower CVD events in high-risk individuals. Although current literature has yet to examine ASA and DHA in preventing CVD, such combination warrants further investigation. To increase adherence to ASA and n3 PUFA supplementation, combination dosage form may be required to improve outcomes.