TY - JOUR
T1 - Does Supplementation of Diet With ‘Fish Oil’ Reduce Blood Pressure?
T2 - A Meta-analysis of Controlled Clinical Trials
AU - Appel, Lawrence J.
AU - Miller, Edgar R.
AU - Seidler, Alexander J.
AU - Whelton, Paul K.
N1 - Funding Information:
siíy School of Medicine, Baltimore, Md; Clinical Investigator AwardK08HL02642fromtheNationalHeart,Lung,andBlood Institute, Bethesda, Md; and a Health of the Public Grant fromThePewCharitableTrust,Philadelphia,Pa,andthe RockefellerFoundation,NewYork,NY.Computationalas¬ sistancewasreceivedfrom the General Clinical Research Cen¬ ter sponsored by grant RR00035 from the National Institutes of Health, Bethesda, Md. PatriciaAnnColemanassistedwithmanuscriptprepa¬ ration. ReprintrequeststotheWelchCenterforPrevention,Ep¬ idemiology and Clinical Research, 600 N Wolfe St, Carnegie 291,Baltimore,MD 21287-6231 (DrAppel).
PY - 1993/6/28
Y1 - 1993/6/28
N2 - Background: Several lines of evidence suggest that supplementation of diet with omega-3 polyunsaturated fatty acids (ω-3) PUFA), commonly referred to as fish oils, may reduce blood pressure (BP). However, most clinical trials of ω-3 PUFA supplementation have been of insufficient size to detect relevant BP changes. Methods: We conducted a meta-analysis of 17 controlled clinical trials of ω-3 PUFA supplementation. To estimate an overall effect of ω-3 PUFA supplementation on BP, we calculated the net BP change in each trial (BP A in ω-3 PUFA group minus BP A in control group), which was then weighted according to the inverse of the variance. Results: In the 11 trials that enrolled normotensive individuals (n=728), ω-3 PUFA supplementation led to significant reductions of systolic BP (SBP) and diastolic BP (DBP) in two and one trials, respectively. In the six studies that enrolled untreated hypertensives (n=291), significant reductions of SBP and DBP were present in two and four trials, respectively. Weighted, pooled estimates of SBP and DBP change (mm Hg) with 95% confidence intervals were —1.0 (—2.0 to 0.0) and —0.5 (—1.2 to +0.2) in the trials of normotensives, and —5.5 (—8.1 to —2.9) and —3.5 (—5.0 to —2.1) in the trials of untreated hypertensives. In 13 of 17 studies, trial duration was less than 3 months. Doses of ω-3 PUFA tended to be high (average dose >3 g/d in 11 trials). The magnitude of BP reduction was greatest at high BP but was not significantly associated with dose of ω-3 PUFA. Side effects, most commonly eructation and a fishy taste, occurred more frequently in ω-3 PUFA participants than in control participants (28% vs 13%, P<.001). Conclusions: Our analyses indicate that diet supplementation with a relatively high dose of ω-3 PUFA, generally more than 3 g/d, can lead to clinically relevant BP reductions in individuals with untreated hypertension. However, use of ω-3 PUFA as antihypertensive therapy will require demonstration of long-term efficacy and patient acceptability of lower doses.
AB - Background: Several lines of evidence suggest that supplementation of diet with omega-3 polyunsaturated fatty acids (ω-3) PUFA), commonly referred to as fish oils, may reduce blood pressure (BP). However, most clinical trials of ω-3 PUFA supplementation have been of insufficient size to detect relevant BP changes. Methods: We conducted a meta-analysis of 17 controlled clinical trials of ω-3 PUFA supplementation. To estimate an overall effect of ω-3 PUFA supplementation on BP, we calculated the net BP change in each trial (BP A in ω-3 PUFA group minus BP A in control group), which was then weighted according to the inverse of the variance. Results: In the 11 trials that enrolled normotensive individuals (n=728), ω-3 PUFA supplementation led to significant reductions of systolic BP (SBP) and diastolic BP (DBP) in two and one trials, respectively. In the six studies that enrolled untreated hypertensives (n=291), significant reductions of SBP and DBP were present in two and four trials, respectively. Weighted, pooled estimates of SBP and DBP change (mm Hg) with 95% confidence intervals were —1.0 (—2.0 to 0.0) and —0.5 (—1.2 to +0.2) in the trials of normotensives, and —5.5 (—8.1 to —2.9) and —3.5 (—5.0 to —2.1) in the trials of untreated hypertensives. In 13 of 17 studies, trial duration was less than 3 months. Doses of ω-3 PUFA tended to be high (average dose >3 g/d in 11 trials). The magnitude of BP reduction was greatest at high BP but was not significantly associated with dose of ω-3 PUFA. Side effects, most commonly eructation and a fishy taste, occurred more frequently in ω-3 PUFA participants than in control participants (28% vs 13%, P<.001). Conclusions: Our analyses indicate that diet supplementation with a relatively high dose of ω-3 PUFA, generally more than 3 g/d, can lead to clinically relevant BP reductions in individuals with untreated hypertension. However, use of ω-3 PUFA as antihypertensive therapy will require demonstration of long-term efficacy and patient acceptability of lower doses.
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U2 - 10.1001/archinte.1993.00410120017003
DO - 10.1001/archinte.1993.00410120017003
M3 - Article
C2 - 8141868
AN - SCOPUS:0027233392
SN - 0003-9926
VL - 153
SP - 1429
EP - 1438
JO - Archives of internal medicine
JF - Archives of internal medicine
IS - 12
ER -