Is fish oil still worth taking for heart health?

Fish oil supports normal heart function but hasn't been shown to prevent heart attacks or strokes in the general population — and at high doses it may actually raise the risk of atrial fibrillation.

Here's where the evidence lands:

• The EU authorises a claim that EPA + DHA contribute to normal heart function at 250 mg/day combined — a maintenance claim, not a disease-prevention one.
• NICE (2023) explicitly advises against offering omega-3 compounds to prevent cardiovascular disease, with one narrow exception: icosapent ethyl added to statins for people with very high triglycerides.
• A large randomised trial in haemodialysis patients (4 g/day of EPA + DHA vs. placebo) found no significant reduction in serious cardiovascular events in that high-risk group 1.
• At prescription doses (4 g/day), the EMA flagged atrial fibrillation as a dose-dependent risk.

The practical upshot: if you eat fatty fish twice a week or more, supplements add little. If you don't, 1–2 g/day of combined EPA + DHA is a reasonable way to meet the baseline intake the EU claim is based on — not as a heart-attack preventer, but as nutritional support for normal cardiac function. The blood-thinning effect is mild but worth mentioning to a doctor if you're on anticoagulants.