In the late 1970s, a lower incidence of myocardial infarction and favorable hemostatic alterations were reported in Greenland Inuits. This observation prompted investigators worldwide to continue research on the role of a specific diet in this population and sparked an ongoing discussion about the potential use of polyunsaturated fatty acids (PUFAs) in the primary prevention of cardiovascular disease (VITAL), and the secondary prevention of primarily coronary artery disease (JELIS, REDUCE‑IT, OMEMI). However, the current evidence to support the preventive value of PUFAs is inconsistent. Seminal clinical trials such as the GISSI‑Prevenzione, JELIS, PREDIMED, or ASCEND differed in their approach to the assessment of cardiovascular effects of n-3 PUFAs and reported divergent results. The questions remain whether eicosapentaenoic acid is the only PUFA offering cardiovascular benefits, what is the importance of PUFA dosing, and, finally, who should receive n-3 PUFA treatment. This article discusses the latest insights into n-3 PUFA use in cardiovascular disease prevention.

中文翻译：

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心血管疾病中的多不饱和脂肪酸：不确定性普遍存在。

在 1970 年代后期，据报道格陵兰因纽特人的心肌梗塞发生率较低且止血效果良好。这一观察结果促使世界各地的研究人员继续研究特定饮食在这一人群中的作用，并引发了关于多不饱和脂肪酸 (PUFA) 在心血管疾病一级预防 (VITAL) 和二级预防中的潜在用途的持续讨论。主要是冠状动脉疾病（JELIS、REDUCE-IT、OMEMI）。然而，目前支持多不饱和脂肪酸预防价值的证据并不一致。GISSI-Prevenzione、JELIS、PREDIMED 或 ASCEND 等开创性临床试验在评估 n-3 PUFA 心血管效应的方法上有所不同，并报告了不同的结果。问题仍然是二十碳五烯酸是否是唯一提供心血管益处的 PUFA，PUFA 剂量的重要性是什么，最后，谁应该接受 n-3 PUFA 治疗。本文讨论了关于 n-3 PUFA 在心血管疾病预防中的应用的最新见解。