Evidence supporting the use of: EPA (eicosapentaenoic acid)
For the health condition: Strokes

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Eicosapentaenoic acid (EPA) is an omega-3 polyunsaturated fatty acid found in marine oils, often studied for its potential cardiovascular benefits, including the prevention of stroke. Scientific interest in EPA and stroke prevention originates from observations that populations consuming diets high in fish oil have lower rates of cardiovascular events, including stroke. Mechanistically, EPA is thought to exert anti-inflammatory, antithrombotic, and lipid-lowering effects, all of which could theoretically reduce stroke risk.

Clinical evidence, however, is mixed and somewhat limited. Several large randomized controlled trials (RCTs) have examined the effect of omega-3 supplementation (including EPA) on stroke incidence. Meta-analyses show a modest reduction in cardiovascular events, but the effect on stroke prevention specifically is less clear, with some studies finding no significant reduction and others suggesting a small benefit. For example, the JELIS trial (using EPA alone) reported a reduction in major coronary events but did not find a statistically significant decrease in stroke rates. Other studies using EPA/DHA combinations have produced inconsistent results.

EPA is not typically used as a treatment for acute stroke but is promoted more for primary or secondary prevention. Major guideline organizations recognize some cardiovascular benefits of fish oil but do not universally recommend it specifically for stroke prevention due to insufficient evidence. Therefore, while there is a scientific rationale for EPA’s use and some supporting data, the evidence is not robust, and guidelines remain cautious.

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