Effects of probiotics supplementation on blood pressure: An umbrella meta-analysis of randomized controlled trials

Nutr Metab Cardiovasc Dis. 2023 Feb;33(2):275-286. doi: 10.1016/j.numecd.2022.09.005. Epub 2022 Oct 12.

Abstract

Aims: Several meta-analyses have revealed that probiotics could lower blood pressure (BP), but the findings were inconsistent. In this regard, an umbrella meta-analysis was carried out to provide a more accurate estimate of the overall impacts of probiotics supplementation on BP.

Data synthesis: We searched the following international databases till November 2021: PubMed, Scopus, EMBASE, Web of Science, and Google Scholar. A random-effects model was applied to evaluate the effects of probiotics on BP. Sensitivity analysis was performed by using the leave-one-out method. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the certainty of evidence. Pooled effect size of 14 meta-analyses with 15,494 participants indicated significant decreases in both systolic (Weighted mean difference (WMD) = -1.96 mmHg; 95% confidence interval (CI): -2.78, -1.14, p < 0.001, and standardized mean difference (SMD) = -2.62; 95% CI: -4.96, -0.28, p < 0.001) and diastolic BP (WMD = -1.28 mmHg; 95% CI: -1.76, -0.79, p < 0.001, and SMD = -0.60 mmHg; 95% CI: -1.08, -0.12, p = 0.014) following probiotics supplementation. Greater effects on SBP were revealed in trials with a mean age of >50 years and the duration of intervention ≤10 weeks. DBP was also more reduced in studies with a dosage of ≥1010 colony forming unit (CFU), and SBP was decreased in patients with hypertension or diabetes analyzing WMD.

Conclusion: The present umbrella meta-analysis suggests probiotics supplementation to improve BP and claims that probiotics could be used as a complementary therapy for controlling high BP.

Prospero id: CRD42022306560.

Keywords: Blood pressure (BP); Probiotics; Systematic review; Umbrella meta-analysis.

Publication types

  • Meta-Analysis

MeSH terms

  • Blood Pressure
  • Dietary Supplements / adverse effects
  • Humans
  • Hypertension* / diagnosis
  • Hypertension* / therapy
  • Middle Aged
  • Probiotics* / adverse effects
  • Randomized Controlled Trials as Topic