Background and purpose Despite achievement of optimal low‐density lipoprotein cholesterol (LDL‐C) control with statin therapy, patients with elevated triglycerides (TGs) and residual cardiovascular risk are commonly encountered in clinical practice. Methods We present information from completed and ongoing clinical trials examining Rx omega‐3s for TG‐lowering and omega‐3 dietary supplements to highlight important differences affecting patient management for nurse practitioners. Conclusions Rx omega‐3s demonstrate robust reductions in TGs and may have a role in reducing residual cardiovascular risk. Products containing docosahexaenoic acid (DHA) may raise LDL‐C and should not be substituted for Rx eicosapentaenoic acid (EPA)‐only icosapent ethyl, which does not raise LDL‐C. Omega‐3 dietary supplements (e.g., fish oils containing EPA and DHA) may be used for general health promotion; however, they are not regulated as medications and concerns regarding quality, purity, safety, and variability of content exist. It is important to advise patients that omega‐3 dietary supplements are not medications and should not be substituted for Rx omega‐3s. Large‐scale cardiovascular outcomes studies are underway for Rx omega‐3s in statin‐treated patients. Implications for practice Nurse practitioners can take an active role in reducing residual cardiovascular risk and educating patients about important differences between Rx omega‐3s and fish oil supplements.

The American Association of Clinical Endocrinology and the American College of Endocrinology Clinical Practice Guideline is a comprehensive, practical tool that can be used to diagnose and manage dyslipidemia, a major risk for the development and progression of atherosclerotic cardiovascular disease. Effective therapies are available to improve lipid profiles and reduce cardiovascular events.

Cardiovascular (CV) risk remains in some patients who are treated with statins. Evidence supports a role for triglycerides (TGs) in CV disease. TG-lowering agent outcomes studies have been inconsistent, but eicosapentaenoic acid significantly reduced coronary events in hypercholesterolemic patients who were treated with statins. Ongoing outcomes studies will clarify the role of TG-lowering treatments in CV risk reduction.