The Evidence for Omega-3s and Blood Pressure
A meta-analysis of 70 randomized controlled trials involving over 4,500 participants found that omega-3 fatty acid supplementation reduces systolic blood pressure by an average of 4.5 mmHg in people with hypertension and 2.1 mmHg in normotensive individuals. The effect is dose-dependent: higher doses (3–4 grams per day of EPA+DHA) produce greater reductions. These are clinically meaningful numbers — a 3 mmHg sustained reduction in systolic pressure reduces cardiovascular mortality risk by approximately 8%.
EPA vs. DHA: Which Matters More
Omega-3 supplements contain two main fatty acids: EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). For blood pressure specifically, EPA appears to have greater anti-inflammatory and antithrombotic effects. For triglyceride reduction, DHA may be slightly superior. High-dose EPA supplements (like Vascepa/icosapentaenoic acid) have demonstrated cardiovascular benefits in clinical trials at doses not achievable through diet alone. For most seniors, a balanced EPA+DHA supplement or regular fatty fish consumption provides the optimal combination.
Food vs. Supplement
Two servings of fatty fish per week (salmon, mackerel, sardines, herring) provide approximately 1.5–2 grams of combined EPA+DHA — sufficient for general cardiovascular protection. Higher therapeutic doses require supplementation. When choosing fish oil supplements, look for products that specify EPA+DHA content (not just "fish oil"), are certified free of mercury and PCBs, and are stored refrigerated to prevent rancidity. Algae-based omega-3 supplements are an excellent alternative for vegetarians and those concerned about fish oil quality — they provide the same EPA and DHA found in fish (fish get their omega-3s from algae anyway).
Important Interactions
High-dose omega-3 supplements have blood-thinning properties. People taking anticoagulants (warfarin, rivaroxaban) or antiplatelet agents (aspirin, clopidogrel) should discuss omega-3 supplementation with their physician before starting. At doses above 3 grams per day, omega-3s can modestly increase bleeding time — relevant if surgery is planned. These interactions don't mean omega-3s should be avoided, but they should be used with medical awareness, particularly at higher therapeutic doses.
