Recommendations Summary
HTN: Omega-3 Fatty Acids 2008
Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.
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Recommendation(s)
Omega-3 Fatty Acids
Advise that the consumption of omega-3 fatty acids may not be beneficial for the management of hypertension, since their consumption does not appear to lower blood pressure.
Rating: Fair
Imperative-
Risks/Harms of Implementing This Recommendation
While no defined intake level at which potential adverse effects of omega-3 polyunsaturated fatty acids has been identified, human in vitro studies report increased free-radical formation and lipid peroxidation with higher amounts of polyunsaturated fatty acids. Lipid peroxidation is thought to be a factor in the development of atherosclerotic plaques.
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Conditions of Application
No conditions specified.
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Potential Costs Associated with Application
None.
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Recommendation Narrative
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Seven randomized clinical trials examined the effect of omega-3 fatty acid intake on blood pressure compared to other dietary fatty acids in both healthy adults and those at increased risk for CVD (hyperlipidemia, diabetes), including individuals with prehypertension and stage 1 hypertension.
- Doses of omega-3 fatty acids were provided in foods or as supplements containing from 0.48 - 4.0 g per day for five to 12 weeks; only one study used a whole diet approach with omega-3 fatty acids comprising 25% of dietary fat. None of the studies reported a significant effect of omega-3 fatty acid consumption on blood pressure (Kriketos et al, 2001; Nestel et al, 2002; Woodman et al, 2002; Dokholyan et al, 2004; Dyerberg et al, 2004; Harrison et al, 2004; Rasmussen et al, 2006).
- However, two of the seven studies reported beneficial effects of omega-3 fatty acid intake on other factors (Nestel et al, 2002; Dyerberg et al, 2004).
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Recommendation Strength Rationale
- Conclusion Statement is Grade II
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Minority Opinions
Consensus reached.
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Risks/Harms of Implementing This Recommendation
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Supporting Evidence
The recommendations were created from the evidence analysis on the following questions. To see detail of the evidence analysis, click the blue hyperlinks below (recommendations rated consensus will not have supporting evidence linked).
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References
Dokholyan, RS, Albert, CM, Appel LJ, Cook NR, Whelton PK, Hennekens, CH, A trial of omega-3 fatty acids for prevention of hyertension, Am J Cardiol. 2004, 93: 1,041-1,043.
Dyerberg J, Eskesen DC, Andersen PW, Astrup A, Buemann B, Christensen JH, Clausen P, Rasmussen BF, Schmidt EB, Tholstrup T, Toft E, Toubro S, Stender S. Effects of trans- and n-3 unsaturated fatty acids on cardiovascular risk markers in healthy mailes. An 8 weeks dietary intervention study. Eur J Clin Nutr. 2004; 58: 1,062-1,070.
Harrison RA, Sagara M, Rajura A, Armitage L, Birt N, Birt CA, Yaori Y, Can foods with added soy-protein or fish-oil reduce risk factors for coronary disease? A factorial randomised controlled trial, Nutr Metab Cardiovasc Dis. 2004, 14: 344-350.
Kriketos AD, Robertson RM, Sharp TA, Drougas H, Reed GW, Storlien LH, Hill JO, Role of weight loss and polyunsaturated fatty acids in improving metabolic fitness in moderately obese, moderately hypertensive subjects, J of Hypertension. 2001 19: 1,745-1,754.
Nestel P, Shige H, Pomeroy S, et al, The n-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid increase systemic arterial compliance in humans. Am J Clin Nutr. 2002, 76: 326-330.
Rasmussen BM, Vessby B, Uusitupa M, Berglund L, Pedersen E, Riccardi G, Rivellese AA, Tapsell L, Hermansen K. Effects of dietary saturated, monounsaturated, and n-3 fatty acids on blood pressure in healthy subjects, Am J Clin Nutr. 2006 83: 221-226.
Woodman RJ, Mori TA, Burke V, Puddey IB, Watts GF, Beilin LJ, Effects of purified eicosapentaenoic and docosahexaenoic acids on glycemic control, blood pressure, and serum lipids in type 2 diabetic patients wih treated hypertension, Am J Clin Nutr. 76: 1,007-1,015, 2002. -
References not graded in Academy of Nutrition and Dietetics Evidence Analysis Process
The Dietary Reference Intakes (DRI) and Recommended Dietary Allowances (RDA) are issued by the Food and Nutrition Board of the Institute of Medicine, National Academy of Sciences.
Available at:
http://ods.od.nih.gov/health_information/Dietary_Reference_Intakes.aspx
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References