Long-Chain Omega-3 Fatty Acids Eicosapentaenoic Acid and Docosahexaenoic Acid and Blood Pressure: A Meta-Analysis of Randomised Controlled Trials

The objective of this meta-analysis was to examine the effect of EPA+DHA, without upper dose limits and including food sources, on blood pressure in RCTs, capturing the substantial volume of randomised controlled trials published in the past 2 years.
Study Design:

  • Random-effects meta-analysis of 70 clinical trials were used
  • Weighted group mean differences and 95% confidence intervals were generated between the EPA+DHA group and placebo.
  • Analyses were conducted for subgroups defined by key subject or study characteristics.



Omega-3 fatty acids can be as effective as or more effective than other lifestyle interventions in lowering blood pressure, including restricting sodium and alcohol intake and increasing physical activity

  • Among all subjects, systolic blood pressure decreased by an average 1.52 mm Hg and diastolic blood pressure by 0.99 mm Hg.
  • Among those with hypertension, the effect was even greater, with an average reduction in systolic blood pressure of 4.51 mm Hg and an average reduction in diastolic BP of 3.05 mm Hg.
  • Among normotensive subjects, the drop in SBP was an average of 1.25 mm Hg and in DBP, 0.62 mm Hg.
  • In comparison, studies with non-treated individuals with high blood pressure have shown that dietary sodium reduction reduces systolic blood pressure by 2–8 mm Hg, physical activity by 4–9 mm Hg, and alcohol by 2–4 mm Hg.



Given that about 60% of the U.S. adult population is reported to have elevated blood pressure,

  • A decrease of 1.25 mm Hg in systolic blood pressure could prevent a pre-hypertensive from becoming hypertensive, and
  • A decrease of 4.51 mm Hg in systolic blood pressure among those with high blood pressure could prevent an individual from having to take medication to control blood pressure levels or prevent an individual from moving toward a more progressive stage of hypertension.
  • Overall, available evidence from RCTs indicates that provision of EPA+DHA reduces systolic blood pressure, while provision of ?2 grams reduces diastolic blood pressure.
  • Since each 2 mm Hg reduction reduces stroke mortality by 6 percent, coronary heart disease mortality by 4 percent, and total mortality by 3 percent, from a clinical and public health perspective, provision of EPA and DHA may lower BP and ultimately reduce the incidence
    of associated chronic diseases.


Miller, et al. Long-Chain Omega-3 Fatty Acids Eicosapentaenoic Acid and Docosahexaenoic Acid and Blood Pressure: A Meta-Analysis of Randomized Controlled Trials. Am J Hypertens 2014 Mar 6.