Does supplementation of diet with 'fish oil' reduce blood pressure? A meta-analysis of controlled clinical trials.
Does supplementation of diet with 'fish oil' reduce blood pressure? A meta-analysis of controlled clinical trials.
复制标题
DOI：
10.1001/archinte.1993.00410120017003
复制
发表时间：
1993-06
影响因子：
--
通讯作者：
L. Appel;E. Miller;A. Seidler;P. Whelton
中科院分区：
文献类型：
--
作者：
L. Appel;E. Miller;A. Seidler;P. Whelton
一些证据表明，饮食中补充omega-3多不饱和脂肪酸（omega-3 PUFA），通常被称为鱼油，可以降低血压（BP）。然而，大多数补充omega-3 PUFA的临床试验都没有足够的规模来检测相关的血压变化。方法：我们对17项补充omega-3 PUFA的对照临床试验进行了荟萃分析。为了估计补充omega-3 PUFA对血压的总体影响，我们计算了每个试验的净血压变化（omega-3 PUFA组的BP δ减去对照组的BP δ），然后根据方差的倒数对其进行加权。结果：在11项纳入正常血压个体（n = 728）的试验中，补充omega-3 PUFA分别在2项和1项试验中显著降低了收缩压（SBP）和舒张压（DBP）。在6项纳入未经治疗的高血压患者的研究中（n = 291），分别有2项和4项试验显示收缩压和舒张压显著降低。在血压正常的试验中，收缩压和舒张压变化（mm Hg）的加权合并估计（95%置信区间）为-1.0（-2.0至0.0）和-0.5(-1.2至+0.2)，在未经治疗的高血压试验中为-5.5（-8.1至-2.9）和-3.5（-5.0至-2.1）。17项研究中有13项试验时间少于3个月。omega-3 PUFA的剂量往往很高（11项试验的平均剂量为3g /d）。血压降低的幅度在血压高时最大，但与omega-3 PUFA的剂量无关。副作用，最常见的是分泌物和腥味，在omega-3 PUFA参与者中比对照组更频繁地发生（28%比13%，P < 0.001）。结论：我们的分析表明，在饮食中补充相对高剂量的omega-3 PUFA，通常超过3g /d，可以导致未经治疗的高血压患者的临床相关血压降低。然而，使用omega-3 PUFA作为降压治疗需要证明其长期疗效和患者对低剂量的可接受性。
BACKGROUND Several lines of evidence suggest that supplementation of diet with omega-3 polyunsaturated fatty acids (omega-3 PUFA), commonly referred to as fish oils, may reduce blood pressure (BP). However, most clinical trials of omega-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 omega-3 PUFA supplementation. To estimate an overall effect of omega-3 PUFA supplementation on BP, we calculated the net BP change in each trial (BP delta in omega-3 PUFA group minus BP delta 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), omega-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 omega-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 omega-3 PUFA. Side effects, most commonly eructation and a fishy taste, occurred more frequently in omega-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 omega-3 PUFA, generally more than 3 g/d, can lead to clinically relevant BP reductions in individuals with untreated hypertension. However, use of omega-3 PUFA as antihypertensive therapy will require demonstration of long-term efficacy and patient acceptability of lower doses.