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Meta-Analysis
. 2014 Jul;27(7):885-96.
doi: 10.1093/ajh/hpu024. Epub 2014 Mar 6.

Long-chain omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid and blood pressure: a meta-analysis of randomized controlled trials

Paige E Miller  1 , Mary Van Elswyk  2 , Dominik D Alexander  3
Affiliations
Meta-Analysis

Long-chain omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid and blood pressure: a meta-analysis of randomized controlled trials

Paige E Miller et al. Am J Hypertens. 2014 Jul.

Abstract

Background: Although a large body of literature has been devoted to examining the relationship between eicosapentaenoic and docosahexaenoic acids (EPA+DHA) and blood pressure, past systematic reviews have been hampered by narrow inclusion criteria and a limited scope of analytical subgroups. In addition, no meta-analysis to date has captured the substantial volume of randomized controlled trials (RCTs) published in the past 2 years. The objective of this meta-analysis was to examine the effect of EPA+DHA, without upper dose limits and including food sources, on blood pressure in RCTs.

Methods: Random-effects meta-analyses were used to generate weighted group mean differences and 95% confidence intervals (CIs) between the EPA+DHA group and the placebo group. Analyses were conducted for subgroups defined by key subject or study characteristics.

Results: Seventy RCTs were included. Compared with placebo, EPA+DHA provision reduced systolic blood pressure (-1.52 mm Hg; 95% confidence interval (CI) = -2.25 to -0.79) and diastolic blood pressure (-0.99 mm Hg; 95% CI = -1.54 to -0.44) in the meta-analyses of all studies combined. The strongest effects of EPA+DHA were observed among untreated hypertensive subjects (systolic blood pressure = -4.51 mm Hg, 95% CI = -6.12 to -2.83; diastolic blood pressure = -3.05 mm Hg, 95% CI = -4.35 to - 1.74), although blood pressure also was lowered among normotensive subjects (systolic blood pressure = -1.25 mm Hg, 95% CI = -2.05 to -0.46; diastolic blood pressure = -0.62 mm Hg, 95% CI = -1.22 to -0.02).

Conclusions: Overall, available evidence from RCTs indicates that provision of EPA+DHA reduces systolic blood pressure, while provision of ≥2 grams reduces diastolic blood pressure.

Keywords: blood pressure; docosahexaenoic acid; eicosapentaenoic acid; fish oil; hypertension; meta-analysis; omega-3; randomized controlled trials; systematic review.

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Figures

Figure 1.
Figure 1.
Flow diagram of literature search and selection of randomized controlled trials (RCTs) for meta-analysis of eicosapentaenoic and docosahexaenoic acids (EPA+DHA) and blood pressure.
Figure 2.
Figure 2.
Results from meta-analyses of randomized controlled trials examining eicosapentaenoic and docosahexaenoic acids (EPA+DHA) provision and (a) systolic blood pressure and (b) diastolic blood pressure among hypertensive subjects. The squares represent average change in blood pressure in individual randomized controlled trials, or individual trial strata, with 95% confidence intervals (CIs). The diamond represents the pooled summary estimate. Knapp (a) is a higher-dose subgroup, and Knapp (b) is a lower-dose subgroup.
Figure 3.
Figure 3.
Results from meta-analyses of randomized controlled trials examining eicosapentaenoic and docosahexaenoic acids (EPA+DHA) and (a) systolic blood pressure and (b) diastolic blood pressure by EPA+DHA dose category. The circle represents the pooled summary estimate across all studies within each dose category, with 95% confidence intervals (CIs). n indicates the number of data points in each dose category, which may be greater than the number of individual studies.
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention. Vital signs: prevalence, treatment, and control of hypertension—United States, 1999–2002 and 2005–2008. MMWR Morbid Mortal Wkly Rep 2011; 60:103–108. - PubMed
    1. Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Makuc DM, Marcus GM, Marelli A, Matchar DB, Moy CS, Mozaffarian D, Mussolino ME, Nichol G, Paynter NP, Soliman EZ, Sorlie PD, Sotoodehnia N, Turan TN, Virani SS, Wong ND, Woo D, Turner MB. Heart disease and stroke statistics—2012 update: a report from the American Heart Association. Circulation 2012; 125:e2–e220. - PMC - PubMed
    1. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jr, Jones DW, Materson BJ, Oparil S, Wright JT, Jr, Roccella EJ. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003; 289:2560–2572. - PubMed
    1. Cabo J, Alonso R, Mata P. Omega-3 fatty acids and blood pressure. Br J Nutr 2012; 107:S195–S200. - PubMed
    1. Hartweg J, Farmer AJ, Holman RR, Neil HAW. Meta-analysis of the effects of n-3 polyunsaturated fatty acids on haematological and thrombogenic factors in type 2 diabetes. Diabetologia 2007; 50:250–258. - PubMed

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