Eicosapentaenoic acid and docosahexaenoic acid containing supplements modulate risk factors for cardiovascular disease: a meta‐analysis of randomised placebo‐control human clinical trials
What this study found
EPA and DHA supplementation showed overall cardiovascular risk factor benefits. Pooled analyses found reductions in triglycerides by 0.368 mmol/L, systolic blood pressure by 2.195 mmHg, diastolic blood pressure by 1.37 mmHg, heart rate by 1.37 bpm, and C-reactive protein by 0.343 mg/L. LDL cholesterol increased by 0.150 mmol/L and HDL cholesterol increased by 0.039 mmol/L, while total cholesterol, TNF-alpha, fibrinogen, platelet count, sICAM-1, sVCAM-1, and FMD were not significantly affected. The triglyceride-lowering effect was dose-dependent, with larger effects at doses above 3 g/day.…
- Study & population
- Meta-analysis of 171 randomized placebo-controlled human clinical trials.
- Intervention
- Randomized placebo-controlled trials evaluated daily supplements containing eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), with doses reported across studies ranging from 180 mg/day to 15000 mg/day and intervention durations varying by trial.
- Key limitation
- Marked clinical heterogeneity across trials, including broad variation in populations, doses, durations, and baseline risk status, limits direct comparability and precision.
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Open PDFOriginal abstract
BACKGROUND Over 200 clinical trials have examined the effect of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplements on risk factors associated with cardiovascular disease. However, an updated analysis of the evidence is lacking. The aim of the present meta-analysis was to quantify the effect of supplements containing EPA and DHA on risk factors for cardiovascular disease. METHODS An analysis was carried on 171 clinical trials with acceptable quality (Jadad score ≥3) that were identified from a comprehensive electronic search strategy of two databases (Pubmed and Cochrane Library). A random effect model was used to obtain an overall estimate on outcomes of interest. Heterogeneity between trial results was tested for using a standard chi-squared test. RESULTS Compared with control, EPA and DHA supplements produced significant reductions of triglycerides of 0.368 mmol L-1 [95% confidence interval (CI) = -0.427 to -0.309], systolic blood pressure of 2.195 mmHg (95% CI = -3.172 to -1.217), diastolic blood pressure of 1.08 mmHg (95% CI = -1.716 to -0.444), heart rate of 1.37 bpm (95% CI = -2.41 to -0.325) and C-reactive protein of 0.343 mg L-1 (95% CI = -0.454 to -0.232). This analysis indicates an increase in both low-density lipoprotein cholesterol (mean difference = 0.150 mmol L-1 ; 95% CI = 0.058-0.243) and high-density lipoprotein cholesterol (mean difference = 0.039 mmol L-1 ; 95% CI = 0.024-0.054). The triglyceride-lowering effect was dose-dependent. CONCLUSIONS The lipid-lowering, hypotensive, anti-arrhythmic and anti-inflammatory actions of EPA and DHA supplements were confirmed in this analysis of randomised placebo-control blinded clinical trials.