CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

July 21st, 2014

Probiotics May Help Reduce Blood Pressure

As interest in probiotics has grown in recent years, some evidence has emerged that probiotics may favorably reduce blood pressure, but trials have been small and inconsistent. Now a meta-analysis published in Hypertension suggests that the blood-pressure lowering effects of probiotics may be genuine.

Saman Khalesi and colleagues analyzed data from nine parallel, randomized, controlled trials including 543 participants. Overall, the probiotic arms had a 3.56-mm Hg reduction in systolic blood pressure and a 2.38-mm Hg reduction in diastolic BP, relative to controls. A larger reduction in blood pressure was observed in trials in which baseline blood pressure was at least 130/85 mm Hg, when treatment lasted at least 8 weeks, and when the daily dose of probiotics contained a larger number of colony-forming units.

The authors note that although the treatment effect was “modest … even a small reduction of BP may have important public health benefits and cardiovascular consequences.” They conclude that their findings “suggest that probiotics may be used as a potential supplement for future interventions to prevent hypertension or improve BP control.”

“The small collection of studies we looked at suggest regular consumption of probiotics can be part of a healthy lifestyle to help reduce high blood pressure, as well as maintain healthy blood pressure levels,” said the lead author of the study, Jing Sun, in a press release. “This includes probiotics in yogurt, fermented and sour milk and cheese, and probiotic supplements.”

 

Categories: General, Prevention
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One Response to “Probiotics May Help Reduce Blood Pressure”

  1. Richard Kones, MD PhD says:
    July 21, 2014 at 9:02 pm

    Unqualified, releasing such information publicly may a disservice to patients. As with other OTC-dominated supplements, there is significant potential for poor treatment, under-treatment, and inappropriate treatment.
    1.”Probiotics” to the lay public collectively means what succeeds in catching their eye in an ad, and claims far exceed evidence. Anyone who has tried to compare products soon realizes the near impossibility of doing so due to insufficient package info and decay in number of living organisms in the preparations over time;
    2. Despite well done studies showing some benefit in several conditions, there is no single preparation that is a magic bullet for any, and individual variation in response is high;
    3. Many of the effects are highly species-specific, a matter which is generally neglected and uncontrolled in OTC preparations;
    4. There is no way to objectively/quantitatively monitor responses short of doing repeated stool analyses for normal flora, which itself has limitations;
    5. Although probiotics certainly can be a part of a healthy diet, and may help a bit, relying on them as serious “treatment” is akin to treating cholesterols of 300 mg/dL with oats. Patients have difficulty with quantitative relationships, and may not realize they need reductions in cholesterol of up to 100%, not 4-8%;
    6. In most yogurt, the probiotics blend nor yield is sufficient to replicate what is needed to reproduce the results of studies.
    7. For acute diarrhea, antibiotic-associated diarrhea, and childhood atopic allergies, evidence is best. Beyond this, it is “promising.”
    8. Probiotics are not innocuous, and data remains limited. Use in critically ill patients, those with suppressed immune systems, and pancreatitis is not advised. Usually gas, bloating, or diarrhea are encountered.
    9. The most recommended probiotic by gastroenterologists contains a single strain, which is not one-size-fits-all.

    Tongue-in-cheek post-script: My Dad, who was a physician, cultured his own yogurt life-long, and “infected” me with the habit, and I eat oats freely.