Tens of thousands of heart attack victims are to be prescribed fish oil supplements under guidelines to be published today. Doctors will tell heart patients to eat at least two portions of oily fish per week or take omega 3 fatty acid tablets for up to four years to reduce the risks of a second attack. Previous research has suggested that eating oily fish or taking the supplements has a range of health benefits including reduced risk of cardiovascular disease and stroke, better immune system functioning, and improved behaviour in primary school age children. A clinical trial found daily 1g doses of highly concentrated omega 3 within three months of a heart attack cut the risk of a patient later dying suddenly by 45 per cent. The recommendation, published by the National Institute for Health and Clinical Excellence (Nice), is part of wide-ranging advice designed to reduce the risks of a secondary attack among the 160,000 people who survive a first heart attack each year. Patients will be told to follow a Mediterranean diet, high in fruit, vegetables, grains, olive oil and fish. Doctors will be told to only prescribe the supplements to those who "will not tolerate" a change of diet and those who have had an attack within the previous three months. The diet, two to four portions of oily fish a week, should consist of 7g of omega 3 fatty acids. Nice estimates that one in five - around 40,000 - patients will be prescribed the pills at an initial annual cost of £7 million to the NHS. Omega 3 and other fatty acids play a key role in maintaining the structure of cell membranes and are important in regulating blood clotting, body temperature, blood pressure, reproduction and the immune system. The richest sources of omega 3 are oily fish, particularly mackerel, herring, salmon, fresh tuna and trout. Almost 840,000 men and 400,000 women in the UK have a heart attack at some point in their lives, with around 70,000 dying each year. Patients will also be advised against taking vitamin A supplements as some research has suggested that it may increase the risk of cardiovascular death in some patients. Nice experts found no evidence to support the taking of vitamin E, C or folic acid to reduce heart attack risk. Doctors will continue to advise heart attack sufferers to give up smoking, maintain a healthy weight, reduce alcohol intake and to exercise for 20 to 30 minutes a day. Nice has, however, resisted calls for omega 3 supplements to be recommended for patients who have had first heart attacks more than three months earlier. Professor Gene Feder, chairman of the committee that developed the guidance, said Nice was not suggesting that other heart attack victims stop taking fish oil supplements, but that based on the available research "what we feel confident about is that three-month window". Dr Gill Leng, Nice implementation systems director, said: "Its [the guideline] overall aim is to provide the growing number of people who now survive a heart attack with the good quality systematic care that is essential to improving long-term outcomes and quality of life." | 
