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Omega-3 fatty acids may reduce BP
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Use of eicosapentaenoic and docosahexaenoic acids was associated with reductions in diastolic and systolic BP, according to results of a new meta-analysis.
Researchers evaluated 70 randomized controlled trials that assessed the impact of eicosapentaenoic acid and docosahexaenoic acid (EPA+DHA) on BP in nonhospitalized adult patients. The studies had a mean duration of 69 days and a mean EPA+DHA dose of 3.8 g per day. The most common sources of EPA and DHA included seafood, fortified foods, fish and algal oil, and purified ethyl esters.
“This meta-analysis of [randomized controlled trials] that examined EPA+DHA provision and BP provides the most comprehensive quantitative summary of the evidence to date,” the researchers wrote. “… The results from our analysis demonstrate that EPA+DHA are as effective, and in some cases more effective, than other lifestyle-related interventions … for lowering BP among hypertensive populations not taking antihypertensive medications.”
Across all studies included in the meta-analysis, EPA+DHA was associated with significantly greater reductions in both systolic (–1.52 mm Hg) and diastolic BP (–0.99 mm Hg) compared with placebo. This effect was especially pronounced in a separate meta-analysis of patients with untreated hypertension, who experienced decreases of –4.51 mm Hg in systolic BP and –3.05 mm Hg in diastolic BP. Significant BP reductions were also reported in an analysis of normotensive patients (–1.25 mm Hg systolic BP, –0.62 mm Hg diastolic BP).
The relationship between EPA+DHA use and systolic BP was not dose-responsive. The researchers observed significant BP reductions at doses between 1 g and <2 g per day (–1.81 mm Hg) and between 3 g and <4 g per day (–3.85 mm Hg). Reductions in diastolic BP were not significant at doses below 2 g per day, but were significant for doses above 2 g per day (–1.09 mm Hg at 2 to <3 g per day; –1.86 mm Hg for 3 g to <4 g per day).
Assessment of potential publication bias indicated modest proclivity for published studies indicating significant systolic BP reduction among EPA+DHA recipients, and a slight indication of bias for studies indicating significant diastolic BP reduction that was modified by region. Studies based outside the United States were more likely to publish results indicating a link between EPA+DHA use and diastolic BP reduction, while studies based in the United States were more likely to publish studies indicating an increase in diastolic BP or null findings from EPA+DHA use.
“The reductions in BP observed in this analysis are not only statistically significant, but also are clinically meaningful,” the researchers wrote. “The statistically significant reduction in [systolic BP] of 1.25 mm Hg noted among normotensive individuals in our analysis would represent a delay of age-related [systolic BP] increase by 2 years and progression from prehypertensive to hypertensive status. The 4.51-mm Hg decrease observed among hypertensive populations not taking antihypertensive medication could prevent an individual from requiring medication to control their hypertension, or could help maintain an individual in a lower stage of progressive hypertension.”
Disclosure: The study was partially supported by the Global Organization for EPA and DHA Omega-3s.
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