Ethyl esters of omega-3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are widely used to support and treat cardiovascular disease (CVD). The most prominent prescription product is icosapent ethyl (an ethyl ester of EPA), which has been approved by regulatory agencies based on substantial clinical trial evidence. Key studies, such as the REDUCE-IT trial (Bhatt DL et al., N Engl J Med 2019), demonstrated a significant reduction in major adverse cardiovascular events in high-risk patients taking icosapent ethyl compared to placebo. Other trials, such as JELIS, also support cardiovascular benefits, although some meta-analyses suggest that effects may depend on the specific formulation and baseline patient characteristics.

The mechanism is believed to involve lowering triglyceride levels and modulating inflammatory and atherogenic processes. The American Heart Association and other expert bodies have issued scientific statements supporting the use of omega-3 ethyl esters in certain populations, particularly those with high triglycerides and established CVD risk. While not all omega-3 preparations (including non-ethyl ester forms and dietary supplements) show consistent benefit, the scientific basis for ethyl esters—especially high-purity EPA—is robust for secondary prevention in selected patients.