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

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 eval-uate 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 par-ticipants 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 differ-ence (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 & LE;10 weeks. DBP was also more reduced in studies with a dosage of & GE;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. & COPY; 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II Uni-versity. Published by Elsevier B.V. All rights reserved.

Automated summary

An umbrella meta-analysis suggests that probiotics supplementation can significantly lower blood pressure and may be used as a complementary therapy for controlling high blood pressure. Trials with a mean age of >50 years and interventions lasting ≤10 weeks show greater effects on systolic blood pressure. Studies with a dosage of ≥1010 colony forming unit (CFU) demonstrate a reduction in diastolic blood pressure, and patients with hypertension or diabetes show a decrease in systolic blood pressure.