Cardiovascular disease (CVD), also known as heart disease, is the leading cause of death worldwide, including here in the U.S. And it’s not like this is a new disease. In fact, here in the U.S., heart disease has held the title of leading killer for over 100 years now. Would it surprise you to learn that heart disease killed more people in this country than all types of cancer and chronic lower respiratory disease combined?
That fact might not surprise you—but it certainly should concern you.
There are known risk factors that can predict CVD, and the good news is some of them are modifiable. Others are not.
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Now, a new, published study in the Journal of Clinical Lipidology has identified another predictor of CVD risk, one that holds just as much weight as smoking and cholesterol, which are two of the most recognized CVD risk predictors.
The study confirms a low omega-3 level is an independent risk factor for CVD. And importantly, just as you can take a blood test to determine your cholesterol levels, you can do the same thing with omega-3 fatty acids EPA and DHA, based on the Omega-3 Index, a blood test that measures the amount of EPA and DHA in your red blood cells.
Once you know your Omega-3 Index test results, just as you would once you learn your cholesterol test results, you activate next steps to reduce your risk for developing CVD. Keep reading as we explain more.
What are Some Traditional CVD Risk Factors?
There are many traditional risk factors for predicting CVD, but some of them are things over which you have no control. Here are three in that category, according to this article:
- Age—yes, you can lie about your age, but you can’t fool your heart, and the fact is that the older you get, the more your risk increases for developing CVD.
- Sex—In general, men develop CVD earlier in life than women and have a higher of risk coronary heart disease than women. Despite the fact that there is a higher percentage of CVD deaths in women (35%) compared to men (32%) according to this study, CVD is still considered “a man’s disease.” But ladies, don’t get too comfortable—women’s heart health issues often are misdiagnosed or just missed, and some women are too busy taking care of their family’s health to pay attention to their own. As women get older and lose the heart-protective effects of estrogen, their heart disease risk increases.
- Family history of heart disease—family history is a well-known risk factor for developing many chronic diseases, including coronary heart disease and diabetes, with diabetes being a chronic disease that damages your blood vessels and the nerves that control your heart, and that’s for starters—read more here. Just another thing to blame on your parents, your grandparents and possibly your siblings, during your therapy sessions.
What are the Known CVD Risk Predictors that You Can Change?
That’s the good news! Many of the known risk factors for developing CVD can be modified by your taking actions to help reduce that risk. For example, the following are just seven (there are more) generally modifiable risk factors that can be impacted for the better by not smoking, taking specific medications, eating a healthier diet, using specific dietary supplements, having an active, exercise-oriented lifestyle, stress management and more.
Seven known—and modifiable—factors that can lead to CVD.
- Smoking—here’s a hint. Don’t!
- High blood pressure
- High blood sugar (diabetes)
- Cholesterol levels (especially high total cholesterol and high LDL levels and low HDL levels)
- Chronic inflammation, chronic stress.
- Obesity
- Omega-3 EPA and DHA blood levels
You’re likely aware about how the first six can lead to CVD. You’re also likely familiar with the kinds of changes you can make to help improve your odds when it comes to modifying your risk factors for developing CVD—again, especially the first six on the list.
So, let’s focus on lucky number seven—and the new study we mentioned earlier that details how your Omega-3 Index is an important predictor of CVD risk, comparable to how smoking and cholesterol are key predictors of CVD.
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What Does the New Study on the Omega-3 Index as a Predictor of CVD Risk Tell Us?
The study, “Omega-3 Index Improves Upon the Pooled Cohort Equation in Predicting Risk for CVD,” was published in the Journal of Clinical Lipidology in March 2025. The study first determined the Omega-3 Index in a population from the Framingham Offspring Cohort of 2,550 participants without atherosclerotic CVD (ASCVD) at baseline, then did a follow-up over a 10-year period.
ASCVD is a very common condition in the U.S. that occurs when sticky plaque build-up in your artery walls obstructs normal blood flow, possibly to the point of rupture. Accurate predictive tools are crucial for identifying those people at an increased risk level for ASCVD, so that they can make changes to lower the chances of developing heart disease.
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The study added prognostic value to predicting CVD by confirming a low omega-3 level is an independent risk factor for CVD, like testing for cholesterol levels. Not only did the study find that the Omega-3 Index contributed statistically significantly to predicting future CVD risk, but it did so to roughly the same extent as other CVD risk factors, including diabetes, cholesterol and smoking.
Further, the study confirmed that a low-cost, low risk intervention of increasing the intake of marine-based omega-3 fatty acids might lower your risk for ASCVD by raising your Omega-3 Index. In other words, the lower your score on the Omega-3 Index, the higher your risk for developing CVD. In addition, the findings suggest that the health effects of omega-3 operate via different mechanisms than lowering cholesterol or blood pressure.
What Else Can We Learn from This Study?
Let’s delve deeper. Not only is the Omega-3 Index a predictor for your risk of CVD, but the Omega-3 Index is also a simple, finger-prick blood test that you can take at home, send to OmegaQuant for the results, and then share those results with your doctor.
The Omega-3 Index test determines your omega-3 EPA and DHA status in your red blood cells, with results of ≥ 8% putting you in the lowest risk category for developing heart disease. A test result of <4% places you in the highest risk zone. Unfortunately, globally, most people fall somewhere in between those two results; and in the U.S., most people fall into the high-risk category.
Just as your doctor tests your cholesterol levels to determine if you are at risk for heart disease, the same is true with testing your Omega-3 Index levels. In both cases, once you know your results, you can modify those numbers as needed to reduce your CVD risk.
Specifically, for your omega-3 EPA and DHA results on the Omega-3 Index, if they are too low, meaning you are at increased risk for developing CVD, increasing your intake of fatty fish, like salmon, or adding fish oil dietary supplements to your diet, should raise your Omega-3 Index. The goal is to get your Omgea-3 Index to ≥ 8%. Testing again around three months after you’ve made those changes will let you know if you’ve successfully met that goal.
According to William S. Harris, Ph.D., senior investigator of this study, and President of the Fatty Acid Research Institute (FARI), “People can test their Omega-3 Index and if it is sub-optimal, they can take steps to correct, and those steps are very safe, cheap and simple—consume more oily fish on a regular basis and/or take omega-3 dietary supplements.”
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Unfortunately, according to Dr. Harris, the average American consumes less than desirable amounts of marine omega-3s, with 90% of the U.S. population at an Omega-3 Index below the optimal level of 8%, which is considered the cardioprotective range.
Dr. Harris hopes that this new study—on top of a previous study showing similar results—will motivate more healthcare providers to start managing their patients’ omega-3 status.
An Earlier Study First Found the Omega-3 Index to be a Strong Predictor of Early Death
That’s right. This new study shows similar results from a 2021 research paper published in the American Journal of Clinical Nutrition which concluded that a low Omega-3 Index is “just as powerful in predicting early death as smoking.” Like the most current study, the 2021 research article mined and analyzed data from the Framingham Study, one of the longest running studies in the world, to provide unique insights into CVD risk factors.
The research paper noted that the risk for CVD can be reduced by changing behavioral factors such as unhealthy diet, physical inactivity, and use of tobacco and alcohol. Further, it showed that biomarkers integrating lifestyle choices might help identify individuals at risk for CVD and be useful to assess treatment approaches, prevent morbidity and delay death.
The paper determined that fatty acids are among those diet-based biomarkers and that the fatty acids most clearly associated with reduced risk for CVD and for total mortality (which is death from any cause), are omega-3 fatty acids EPA and DHA.
In fact, the authors pointed to a 2018 report that included 2,500 participants in the Framingham Offspring Cohort followed for a median of 7.3 years (i.e., between ages ∼66 and 73), with a baseline Omega-3 Index that was significantly and inversely associated with risk for death from all causes.
It turned out that individuals with the highest Omega-3 Index were 33% less likely to succumb during the follow-up years compared with those with the lowest Omega-3 Index. They also noted similar associations in other studies, including the Heart and Soul Study and the Ludwigshafen Risk and Cardiovascular Health Study.
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When the 2021 research paper was published, the lead researcher, Michael McBurney, Ph.D., pointed out in a press release that in Japan, where the mean Omega-3 Index is greater than 8%, the expected life span is around five years longer than it is in the United States, where the mean Omega-3 Index is about 5%. Said Dr. McBurney, “in practice, dietary choices that change the Omega-3 Index may prolong life.”
In the final combined model from the research paper, smoking and the Omega-3 Index “seem to be the most easily modified risk factors,” said Dr. McBurney. He added that data from the research paper showed that “being a current smoker (at age 65) is predicted to subtract more than four years of life (compared with not smoking), a life shortening equivalent to having a low vs. a high Omega-3 Index.”
Dr. Harris, who was also an author on this 2021 research study, suggested that with regard to predicting total mortality, the Omega-3 Index data were as useful as the information from lipid levels, blood pressure, smoking and diabetic status, leading him to conclude that “this speaks to the power of the Omega-3 Index as a risk factor and should be considered just as important as the other established risk factors, and maybe even more so.”
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What are the Key Take-Aways from These Studies?
In summary:
- The Omega-3 Index is established as an independent predictor of CVD risk, along with long-established predictors such as cholesterol, smoking, diabetes and others.
- The Omega-3 Index, as a predictor of CVD risk, and the accompanying dietary-based risk modifiers (e.g., adding omega-3 fatty acids EPA and DHA through fatty fish or fish oil supplements) used to increase the Omega-3 Index presents an important opportunity for doctors, dietitians and other healthcare practitioners when counseling patients on reducing the risk of heart disease.
- The Omega-3 Index test can be administered by a doctor’s order, or consumers can take an at-home, self-test from OmegaQuant and use the resulting recommendations to increase their Omega-3 Index, if needed, to reach the targeted goal of ≥ 8% omega-3 EPA and DHA for a cardioprotective effect. Talk with your doctor or other healthcare practitioner for personal advice.
