A daily intake of omega-3 fatty acids of about 3 grams, from supplements or food, can lower blood pressure, according to a new meta-analysis.
The results showed a substantial reduction in diastolic and systolic blood pressure when individuals consumed a moderate amount of omega-3 fatty acids, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) combined, at doses of 2 to 3 grams per day.
This association for systolic blood pressure was slightly stronger in study groups with a mean age of 45 years or older, reported Xin Zhang, PhD, of Macau University of Science and Technology in Taipa, Thailand. China, and his colleagues.
The results were published online June 1 in the Journal of the American Heart Association.
This report expands the previous literature by including more recent studies and uses a new statistical method, note the study authors.
“An optimal dose of omega-3 fatty acids is potentially necessary for blood pressure control in the general population, but people at high risk of developing cardiovascular disease may benefit from higher doses,” the researchers conclude.
Previous research on omega-3 fatty acids over the past 25 years has shown conflicting results, noted Srihari S. Naidu, MD, professor of medicine at New York Medical College at Valhalla, who was not involved in the study. ‘study.
“The most recent large trials, two of which – one being STRENGTH and the other being REDUCE-IT – have shown conflicting results, and more importantly, they have also shown that there may be an increased risk of bleeding and other complications such as atrial fibrillation,” Naidu said.
“Most cardiovascular professionals like myself are a bit averse to the use of these drugs, particularly because we have an aging population that has atrial fibrillation and a tendency to bleed, especially if they’ve had stents or d ‘other cardiovascular procedures,’ he said. lecoeur.org | Medscape Cardiology during a telephone interview.
The meta-analysis was based on 71 randomized controlled trials that included 4973 participants. Essays were selected if they were published before May 7, 2021; analyzed the link between blood pressure and various omega-3 fatty acids, such as DHA, EPA or both; and had study participants aged 18 or older.
The analysis used a new “omit one” research technique. For the sensitivity analysis, the investigators adopted an approach whereby they performed numerous dose-response assessments to determine the influence of the missing research on the change in total mean blood pressure.
“A nonlinear association was found in all or most subgroups represented by J-shaped dose-response curves,” the authors report.
Optimal intakes of omega-3 fatty acids associated with reductions in systolic and diastolic blood pressure have been observed with “moderate doses”, they note, between 2 grams per day, associated with reductions in systolic blood pressure of 2.61 mm Hg and 1.64 mm Hg diastolic and 3 grams per day, with a systolic blood pressure reduction of 2.61 mm Hg and a diastolic blood pressure reduction of 1.69 mm Hg.
However, exceeding the recommended 3 grams per day of omega-3 fatty acid intake was not associated with other benefits, especially in normotensive patients, they note.
Notably, subgroup analysis showed that the elderly, those with hypertension, and those with hyperlipidemia had greater responses with higher doses.
“Not quite new,“ but “Robust”
In an accompanying editorial, Marc George, MRCP, PhD, Queen Mary University of London, Royal London Hospital Barts Health NHS Trust, and Ajay Gupta, MD, PhD, William Harvey Research Institute, Barts & The London School of Medicine and Dentistry , UK, point out that “although these findings are not entirely new, they are robust and inform the long-standing debate about the role of omega-3 polyunsaturated fatty acids (PUFAs) in modifying cardiovascular risk”.
Despite the uncertainty surrounding the discordant results from randomized trials, they note that “the pooled data suggest a modest net beneficial effect of omega-3 PUFAs, particularly on cardiovascular mortality in patients at high risk and with elevated triglycerides.”
The results of the analysis show that consumption of omega-3 fatty acids is associated with a blood pressure lowering effect, “and a dose of 2-3 grams appears to be optimal,” they write. “Given the modest effect on triglycerides, this blood pressure lowering impact, along with their other pleiotropic effects, is likely the missing link in explaining the reduction in cardiovascular risk observed in REDUCE‐IT and the meta‐ subsequent analyses.
However, further randomized trials and post-marketing studies are needed to “address the remaining questions, particularly the one that has been raised by the disparity between REDUCE-IT and STRENGTH of EPA monotherapy versus the combination of EPA and DHA,” they conclude.
“As a result, omega-3 PUFAs are not quite ready for prime time yet, and physicians should keep an open mind about these compounds with a keen awareness of the mixed evidence base and potential risks. increase in atrial fibrillation and bleeding when prescribed,” they add. .
Zhang, Naidu, George and Gupta reported no relevant financial relationships. The study was funded by the Macao Science and Technology Development Fund and faculty research grants from Macao University of Science and Technology.
J Am Heart Assoc. Published online June 1, 2022. Full Text, Editorial
Ashley Lyles is an award-winning medical journalist. She is a graduate of New York University’s Science, Health, and Environmental Reporting program. Previously, she studied professional writing at Michigan State University, where she also took pre-medical courses. His work has appeared in outlets such as The New York Times Daily 360, PBS NewsHour, The Huffington Post, Undark, The Root, Psychology Today, Insider, and Tonic (Health by Vice), among other publications.
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