Omega-3 Fatty Acid Supplementation and Vascular Health Biomarkers - A Systematic Review and Meta-Analysis
Abstract
Background: Cardiovascular diseases (CVDs) remain the leading global cause of death, partly due to vascular dysfunction. Dietary supplements, including omega-3 fatty acids, are suggested to support vascular health, but their therapeutic effectiveness and optimal dosing are still uncertain.
Objectives: This systematic review and meta-analysis study assessed the efficacy and dose-response effects of omega-3 fatty acids on vascular health biomarkers in individuals with CVDs.
Data sources: A comprehensive search of PubMed, Scopus, Web of Science, and the Cochrane Library was conducted through May 2025.
Study selection: Eligible randomized controlled trials (RCTs) with a minimum intervention duration of four weeks.
Data extraction and synthesis: Two reviewers independently extracted data and assessed study quality. Data were synthesized as weighted mean differences (WMDs) with 95% confidence intervals (CIs). Risk of bias was assessed using the Cochrane tool, and the certainty of the evidence (CoE) was appraised using the GRADE framework.
Main outcome(s) and measure(s): The pulse wave velocity (PWV), augmentation index (AIx), and flow-mediated dilation (FMD).
Results: Twenty RCTs involving 1,208 participants were included, with 80% judged at low risk of bias. Omega-3 supplementation (0.3-4.7 g/day) showed no significant effect on PWV, including in subgroups with hypertension or established CVDs. In contrast, omega-3s improved AIx. FMD elevations were greater for eicosapentaenoic…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,208 participants or records.
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