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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|
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|
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|
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|
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|
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|
|
|
|
 |
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|
|
|
|
 |
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
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|
|
|
|
 |
|
 P. Angerer, W. Kothny, S. Stork, and C. von Schacky Effect of dietary supplementation with {omega}-3 fatty acids on progression of atherosclerosis in carotid arteries Cardiovasc Res, April 1, 2002; 54(1): 183 - 190. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
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|
|
|
|
|
|
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|
|
|
|
|
|
T Holm, A.K Andreassen, P Aukrust, K Andersen, O.R Geiran, J Kjekshus, S Simonsen, and L Gullestad Omega-3 fatty acids improve blood pressure control and preserve renal function in hypertensive heart transplant recipients Eur. Heart J., March 1, 2001; 22(5): 428 - 436. [Abstract] [PDF]
|
|
|
|
 |
|
 M. B. Engler and M. M. Engler Docosahexaenoic Acid-Induced Vasorelaxation in Hypertensive Rats: Mechanisms of Action Biol Res Nurs, October 1, 2000; 2(2): 85 - 95. [Abstract] [PDF]
|
|
|
|
|
|
T. A. Mori, G. F. Watts, V. Burke, E. Hilme, I. B. Puddey, and L. J. Beilin Differential Effects of Eicosapentaenoic Acid and Docosahexaenoic Acid on Vascular Reactivity of the Forearm Microcirculation in Hyperlipidemic, Overweight Men Circulation, September 12, 2000; 102(11): 1264 - 1269. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A Mori, V. Burke, I. B Puddey, G. F Watts, D. N O'Neal, J. D Best, and L. J Beilin Purified eicosapentaenoic and docosahexaenoic acids have differential effects on serum lipids and lipoproteins, LDL particle size, glucose, and insulin in mildly hyperlipidemic men Am. J. Clinical Nutrition, May 1, 2000; 71(5): 1085 - 1094. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A Mori, D. Q Bao, V. Burke, I. B Puddey, G. F Watts, and L. J Beilin Dietary fish as a major component of a weight-loss diet: effect on serum lipids, glucose, and insulin metabolism in overweight hypertensive subjects Am. J. Clinical Nutrition, November 1, 1999; 70(5): 817 - 825. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. A. McCarron and M. E. Reusser Finding Consensus in the Dietary Calcium-Blood Pressure Debate J. Am. Coll. Nutr., October 1, 1999; 18(90005): 398S - 405. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Grimsgaard, K. H. Bonaa, B. K. Jacobsen, and K. S. Bjerve Plasma Saturated and Linoleic Fatty Acids Are Independently Associated With Blood Pressure Hypertension, September 1, 1999; 34(3): 478 - 483. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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]
|
|
|
|
|
|
D. Q. Bao, T. A. Mori, V. Burke, I. B. Puddey, and L. J. Beilin Effects of Dietary Fish and Weight Reduction on Ambulatory Blood Pressure in Overweight Hypertensives Hypertension, October 1, 1998; 32(4): 710 - 717. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. K. Goode, S. Garcia, and A. M. Heagerty Dietary Supplementation With Marine Fish Oil Improves In Vitro Small Artery Endothelial Function in Hypercholesterolemic Patients : A Double-Blind Placebo-Controlled Study Circulation, November 4, 1997; 96(9): 2802 - 2807. [Abstract] [Full Text]
|
|
|
|
|
|
N. J. Stone Fish Consumption, Fish Oil, Lipids, and Coronary Heart Disease Circulation, November 1, 1996; 94(9): 2337 - 2340. [Full Text]
|
|
|
|
 |
|
 Increasing fish oil intake - any net benefits? DTB, August 1, 1996; 34(8): 60 - 62. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Toft, K. H. Bonaa, O. C. Ingebretsen, A. Nordoy, and T. Jenssen Effects of n-3 Polyunsaturated Fatty Acids on Glucose Homeostasis and Blood Pressure in Essential Hypertension: A Randomized, Controlled Trial Ann Intern Med, December 15, 1995; 123(12): 911 - 918. [Abstract] [Full Text]
|
|
|
|
 |
|
 J. A. Hall and R. Rosenthal Interpreting and Evaluating Meta-Analysis Eval Health Prof, December 1, 1995; 18(4): 393 - 407. [Abstract] [PDF]
|
|
|
|
 |
|
 B N C Prichard, C C T Smith, K L E Ling, and D J Betteridge Fish oils and cardiovascular disease BMJ, April 1, 1995; 310(6983): 819 - 820. [Full Text]
|
|
|
|
 |
|
 W. Willett Diet and health: what should we eat? Science, April 22, 1994; 264(5158): 532 - 537. [Abstract] [PDF]
|
|
|
|
 |
|
 DOES FISH OIL LOWER BLOOD PRESSURE? Journal Watch (General), August 20, 1993; 1993(820): 3 - 3. [Full Text]
|
|