Chronic heart failure (HF) represents a significant health care burden. Over the past few decades, there have been considerable data supporting the benefits of omega-3 polyunsaturated fatty acids (PUFAs) on overall cardiovascular health.

Reasons for the potential benefits of omega-3 PUFAs are multifactorial and not completely understood. It is likely that the culmination of multiple effects collectively help to prevent the development and slow the progression of chronic HF.

A number of key epidemiologic and randomized trials have provided the basis of evidence in support of omega-3 PUFA supplementation in HF. This article reviews the benefits of omega-3 PUFAs and discusses the implications of recent trials. While the benefits seen in patients with chronic HF are modest at best, we believe the balance of evidence still favors the continuation of omega-3 PUFA supplementation in patients with chronic HF.