EPA (Eicosapentaenoic Acid)
Research reviewed: Up until 03/2026
EPA (Eicosapentaenoic Acid) (Eicosapentaenoic acid (C20:5 n-3)) is a dietary supplement with 12 published peer-reviewed studies involving 82,066 participants, researched for Cardiovascular Event Reduction, Triglyceride Lowering & Blood Pressure, Meta-analyses and 1 more areas.
Evidence at a Glance
Strength is scored by study design, sample size, study type, and outcomes
Cardiovascular Event Reduction
StrongTriglyceride Lowering & Blood Pressure
ModerateMeta-analyses
ModerateClinical trials
ModerateResearch Visualised
Visual breakdown of the clinical data.
Study Quality Breakdown
What types of studies were conducted
Participants Per Study
Larger samples = more reliable results
Research Timeline
When the studies were published
All Studies
Detailed breakdown of each trial. Click to expand.
Cardiovascular Event Reduction
To assess whether EPA supplementation reduces major coronary events in hypercholesterolaemic patients on statins.
Study Type
Randomised, open-label, blinded endpoint trial (JELIS)
Purpose
To assess whether EPA supplementation reduces major coronary events in hypercholesterolaemic patients on statins.
Dose
1,800 mg/day highly purified EPA + statin
Participants
18,645 hypercholesterolaemic patients (JELIS trial, Japan)
Duration
4.6 years median
Results
EPA supplementation reduced major coronary events by 19% vs statin alone (2.8% vs 3.5%, p=0.011). Unstable angina and non-fatal MI were significantly reduced. Particularly effective in patients with pre-existing coronary artery disease.
How They Measured It
Major coronary events (sudden cardiac death, fatal/non-fatal MI, unstable angina, revascularisation)
To investigate whether high-dose icosapentaenoic acid (EPA) reduces cardiovascular events in statin-treated patients with elevated TG.
Study Type
Randomised, double-blind, placebo-controlled trial (REDUCE-IT)
Purpose
To investigate whether high-dose icosapentaenoic acid (EPA) reduces cardiovascular events in statin-treated patients with elevated TG.
Dose
4 g/day icosapentaenoic acid (Vascepa/icosapent ethyl)
Participants
8,179 statin-treated patients with elevated TG (≥1.52 mmol/L) and established CVD or diabetes with risk factors
Duration
4.9 years median
Results
High-dose EPA reduced the primary composite endpoint by 25% (17.2% vs 22.0%, HR 0.75, p<0.001). Cardiovascular death reduced by 20%. Ischaemic stroke reduced by 28%. Slight increase in atrial fibrillation noted.
How They Measured It
Composite endpoint: cardiovascular death, non-fatal MI, non-fatal stroke, coronary revascularisation, unstable angina
To compare cardiovascular outcomes between pure EPA, pure DHA, and combined EPA+DHA formulations.
Study Type
Systematic review and network meta-analysis
Purpose
To compare cardiovascular outcomes between pure EPA, pure DHA, and combined EPA+DHA formulations.
Dose
Various EPA or EPA+DHA formulations
Participants
Pooled from >40,000 participants across large RCTs
Duration
Various
Results
Pure EPA (but not DHA alone or EPA+DHA combined) significantly reduced major adverse cardiovascular events. Superiority of pure EPA was noted, potentially due to EPA-specific anti-inflammatory and anti-atherogenic mechanisms.
How They Measured It
Network meta-analysis of cardiovascular endpoints
To investigate incremental effects of EPA in statin-treated coronary artery disease patients.
Study Type
Randomised controlled trial — subgroup analysis (JELIS-CAD)
Purpose
To investigate incremental effects of EPA in statin-treated coronary artery disease patients.
Dose
1,800 mg/day EPA added to statin
Participants
14,981 CAD patients (subgroup from JELIS)
Duration
4.6 years
Results
In patients with pre-existing CAD, EPA reduced major coronary events by 23% vs statin alone (p=0.048). TG was significantly reduced. Benefit particularly pronounced in patients with elevated TG and low HDL-C.
How They Measured It
Coronary events, TG levels, inflammatory markers
Triglyceride Lowering & Blood Pressure
To compare the differential effects of EPA vs DHA on triglycerides and other cardiovascular risk factors.
Study Type
Systematic review of randomised controlled trials
Purpose
To compare the differential effects of EPA vs DHA on triglycerides and other cardiovascular risk factors.
Dose
Various EPA-only and DHA-only preparations
Participants
9 unique RCTs included
Duration
Various
Results
Both EPA and DHA reduce TG significantly. EPA showed greater anti-inflammatory effects (lower CRP). DHA raised LDL-C slightly more than EPA. Both reduced blood pressure similarly.
How They Measured It
Pooled TG, LDL-C, HDL-C, blood pressure from head-to-head and placebo-controlled RCTs
To assess cardiovascular risk factor effects of EPA and DHA supplementation in placebo-controlled human trials.
Study Type
Meta-analysis of randomised controlled trials
Purpose
To assess cardiovascular risk factor effects of EPA and DHA supplementation in placebo-controlled human trials.
Dose
Various doses of EPA/DHA supplements
Participants
Multiple RCTs included
Duration
Various
Results
EPA+DHA significantly reduced TG in a dose-dependent manner, lowered blood pressure, reduced heart rate, and had anti-inflammatory effects. Dose-response particularly strong for TG reduction.
How They Measured It
Lipid panel, blood pressure, CRP, heart rate from pooled RCTs
To quantify blood pressure-lowering effects of long-chain omega-3 fatty acids (EPA+DHA).
Study Type
Meta-analysis of randomised controlled trials
Purpose
To quantify blood pressure-lowering effects of long-chain omega-3 fatty acids (EPA+DHA).
Dose
Various (0.3–15 g/day EPA+DHA)
Participants
70 RCTs
Duration
Various
Results
EPA+DHA supplementation reduced SBP by 1.52 mmHg and DBP by 0.99 mmHg overall. Greater reductions in hypertensive subjects and at higher doses. Dose-dependent blood pressure reduction demonstrated.
How They Measured It
SBP and DBP pooled from 70 RCTs
To assess whether EPA+DHA is associated with reduced coronary heart disease risk.
Study Type
Meta-analysis and review
Purpose
To assess whether EPA+DHA is associated with reduced coronary heart disease risk.
Dose
Various dietary and supplemental intakes
Participants
17 prospective cohorts and 7 RCTs
Duration
Various
Results
EPA+DHA associated with 6% lower CHD risk per 0.3 g/day increment. Greater benefit in high-risk populations. Secondary prevention RCTs showed stronger effects than primary prevention.
How They Measured It
Relative risk of CHD from pooled prospective cohorts and RCTs
To synthesise evidence (2020–2025) on EPA and DHA mechanisms and cardiovascular outcomes.
Study Type
Review — updated synthesis 2020–2025
Purpose
To synthesise evidence (2020–2025) on EPA and DHA mechanisms and cardiovascular outcomes.
Dose
Various supplemental and dietary intakes
Participants
Review of multiple studies
Duration
Various
Results
EPA and DHA modulate lipid metabolism, platelet function, endothelial function, inflammation, ion channels, and autonomic function. Higher circulating EPA and DHA levels consistently linked to lower cardiovascular event rates in updated cohort and meta-analysis data.
How They Measured It
Narrative review of mechanistic, observational, and clinical trial data
To evaluate the anti-inflammatory effects of EPA alone vs EPA+DHA in patients with metabolic syndrome.
Study Type
Randomised, double-blind, placebo-controlled
Purpose
To evaluate the anti-inflammatory effects of EPA alone vs EPA+DHA in patients with metabolic syndrome.
Dose
1.8 g/day EPA or EPA+DHA combined
Participants
165 patients with metabolic syndrome
Duration
12 weeks
Results
Both EPA alone and EPA+DHA significantly reduced CRP and TG vs placebo. EPA alone produced significantly greater CRP and IL-6 reductions. Blood pressure improvements were comparable between groups.
How They Measured It
CRP, IL-6, TNF-alpha, serum TG, blood pressure
Meta-analyses
To characterize dose-response relationships between omega-3 fatty acid (EPA/DHA) intake and blood lipid changes.
Study Type
Dose-response meta-analysis of 90 RCTs
Purpose
To characterize dose-response relationships between omega-3 fatty acid (EPA/DHA) intake and blood lipid changes.
Dose
Variable doses across 90 RCTs
Participants
72,598 participants across 90 RCTs
Duration
Variable per included RCTs
Results
Omega-3 intake near linearly lowers triglycerides and non-HDL cholesterol, especially at >2 g/day in hyperlipidemia. J-shaped dose-response for LDL/HDL cholesterol.
How They Measured It
Random-effects 1-stage cubic spline regression; changes in triglycerides, LDL, HDL, non-HDL cholesterol
Clinical trials
To assess clinical benefits of icosapent ethyl (EPA) added to statin therapy for secondary cardiovascular prevention (RESPECT-EPA trial).
Study Type
Randomized, open-label, controlled trial
Purpose
To assess clinical benefits of icosapent ethyl (EPA) added to statin therapy for secondary cardiovascular prevention (RESPECT-EPA trial).
Dose
1.8 g/day icosapent ethyl (EPA) for median 36 months
Participants
3,003 patients with stable coronary artery disease (Japan)
Duration
Median 36 months
Results
EPA supplementation significantly reduced non-HDL cholesterol and EPA/AA ratio. Did not significantly reduce primary composite cardiovascular endpoint vs statin alone in this population. Plaque progression was attenuated.
How They Measured It
Major adverse cardiovascular events, EPA/AA ratio, plaque regression on coronary CT angiography
Frequently Asked Questions
Common questions about EPA (Eicosapentaenoic Acid) research
There are currently 12 peer-reviewed studies on EPA (Eicosapentaenoic Acid) (Eicosapentaenoic acid (C20:5 n-3)), involving 82,066 total participants. Research covers Cardiovascular event reduction, Triglyceride lowering, Blood pressure management and 1 more areas. The overall evidence strength is rated as Strong.
The evidence is currently rated as "Strong Evidence". This rating is based on study design quality (randomisation, blinding, placebo controls), sample sizes, study types (6 human studies), and reported outcomes.
EPA (Eicosapentaenoic Acid) has been researched for: Cardiovascular event reduction, Triglyceride lowering, Blood pressure management, Anti-inflammatory effects. Each area has its own body of evidence which you can explore in the study breakdowns above.
Yes, 6 out of 12 studies are human trials. Human trials carry more weight in our evidence scoring system.
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