Effect of omega-3 Long-Chain Polyunsaturated Fatty Acid Supplementation on Heart Rate: A Meta-Analysis of Randomized Controlled Trials

Eur J Clin Nutr. 2018 Jun;72(6):805-817. doi: 10.1038/s41430-017-0052-3. Epub 2017 Dec 28.

Abstract

Background: Elevated resting heart rate (HR) has emerged as a new risk factor for all-cause and cardiovascular mortality. The effect of marine-derived omega-3 long-chain polyunsaturated fatty acid (n-3 LCPUFAs) supplementation on HR was investigated as an outcome in many clinical trials. The present study was to provide an updated meta-analysis on the HR-slowing effect of n-3 LCPUFAs, and to differentiate the chronotropic effect between eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

Methods: PubMed and Cochrane databases were searched for relevant articles examining the effects of n-3 PUFAs on HR through May 2017. A random-effects model was used to generate the pooled effect sizes and 95% confidence intervals (CIs). The pooled effect sizes were presented as weighted mean differences (WMDs).

Results: A total of 51 randomized controlled trials (RCTs) with approximately 3000 participants were included in this meta-analysis. Compared to placebo, n-3 PUFA supplementation mildly but significantly reduced HR (-2.23 bpm; 95% CI: -3.07, -1.40 bpm). Moderate evidence of heterogeneity was observed among included trials (I 2 = 49.1%, P heterogeneity < 0.001). When DHA and EPA were separately administered, modest HR reduction was observed in trials that supplemented with DHA (-2.47 bpm; 95% CI: -3.47, -1.46 bpm), but not in trials with EPA.

Conclusions: The present meta-analysis provides strong clinical evidence demonstrating the effect of heart rate reduction by n-3 LCPUFA supplementation. When DHA or EPA administered alone, heart rate was slowed by DHA rather than by EPA.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Dietary Supplements*
  • Docosahexaenoic Acids / administration & dosage
  • Eicosapentaenoic Acid / administration & dosage
  • Eicosapentaenoic Acid / analogs & derivatives
  • Fatty Acids, Omega-3 / administration & dosage*
  • Heart Rate*
  • Humans
  • Randomized Controlled Trials as Topic

Substances

  • Fatty Acids, Omega-3
  • Docosahexaenoic Acids
  • eicosapentaenoic acid ethyl ester
  • Eicosapentaenoic Acid