Circulation, Vol 88, 523-533, Copyright © 1993 by American Heart Association
MC Morris, F Sacks and B Rosner
BACKGROUND. In a meta-analysis of 31 placebo-controlled trials on 1356
subjects, we examined the effect of omega-3 fatty acids in fish oil on
blood pressure by grouping studies that were similar in fish oil dose,
length of treatment, health of the subjects, or study design. METHODS AND
RESULTS. The mean reduction in blood pressure caused by fish oil for the 31
studies was -3.0/-1.5 mm Hg (95% confidence intervals: systolic blood
pressure: -4.5, -1.5; diastolic blood pressure: -2.2, - 0.8). There was a
statistically significant dose-response effect when studies were grouped by
omega-3 fatty acid dose: -1.3/-0.7 mm Hg at doses < or = 3 g/d,
-2.9/-1.6 mm Hg at 3.3 to 7 g/d, and -8.1/-5.8 mm Hg at 15 g/d. Both
eicosapentaenoic acid and docosahexaenoic acid were significantly related
to blood pressure response. There was no effect on blood pressure in eight
studies of "healthy" persons (mean reduction, -0.4/-0.7 mm Hg) at an
overall mean dose of 4.2 g omega-3 fatty acids/d. By contrast, there was a
significant effect of -3.4/-2.0 mm Hg in the group of hypertensive studies
with a mean fish oil dose of 5.6 g/d and on systolic blood pressure only in
six studies of hypercholesterolemic patients (-4.4/-1.1 mm Hg) with a mean
dose of 4.0 g/d. A nonsignificant decrease in blood pressure was observed
in four studies of patients with atherosclerotic cardiovascular disease
(-6.3/- 2.9 mm Hg). Variations in the length of treatment (from 3 to 24
weeks), type of placebo, and study design (crossover or parallel groups)
did not appear to account for inconsistent findings among studies.
CONCLUSIONS. There is a dose-response effect of fish oil on blood pressure
of -0.66/-0.35 mm Hg/g omega-3 fatty acids. The hypotensive effect may be
strongest in hypertensive subjects and those with clinical atherosclerotic
disease or hypercholesterolemia.
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Does fish oil lower blood pressure? A meta-analysis of controlled trials
Department of Epidemiology, Harvard School of Public Health.
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T. A. Mori, D. Q. Bao, V. Burke, I. B. Puddey, and L. J. Beilin Docosahexaenoic Acid but Not Eicosapentaenoic Acid Lowers Ambulatory Blood Pressure and Heart Rate in Humans Hypertension, August 1, 1999; 34(2): 253 - 260. [Abstract] [Full Text] [PDF]
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