The effect of psyllium supplementation on blood pressure: a systematic review and meta-analysis of randomized controlled trials

Abstract

Background/Aims: Global incidence of hypertension is estimated to be, in excess of, one billion people, and given the efficacy of soluble dietary fibers, in particular, Psyllium, to positively impact blood pressure in patients with hypertension, it is of clinical importance that consensus on its supplementation be established. Therefore, the aim of the study was systematically review and meta-analyze the effect of psyllium supplementation on blood pressure of hypertensive patients in randomized controlled trials. Methods: We searched six universal databases including; Pubmed/Medline, Ovid, Cochrane Library, Google Scholar, Embase, and Scopus until November 2018. Both combined and stratified analyzes were conducted. A fixed-effects or random-effects model was used to assess the mean effect sizes. Results: An eventual 11 trials with 592 participants were considered as eligible for inclusion in the present meta-analysis. The meta-analysis revealed a significant reduction of 2.04 mmHg in systolic blood pressure (weighted mean difference, -2.04; 95% confidence interval, -2.82 to -1.63; p < 0.001). Whilst meta-regression highlighted that the hypotensive effect of psyllium was stronger in subjects with higher baseline blood pressure. Conclusions: Given the overarching benefits and lack of reported side effects, particularly for hypertensive patients, health care providers and clinicians should consider the use of psyllium supplementation for the treatment or abatement of hypertension, or hypertensive symptoms.

The Role of Diet in the Prevention of Hypertension and Management of Blood Pressure: An Umbrella Review of Meta-Analyses of Interventional and Observational Studies

“…No evidence on carbohydrates was rated as high quality by NutriGrade ( Figure 9 A and B). There was moderate-quality evidence showing significant reductions in SBP and DBP with psyllium intake [ 156 ] and inositol [ 157 ]. There was moderate-quality evidence showing a nonsignificant reduction in SBP and DBP with inulin [ 158 ].…”

Associations between dietary fiber intake and cardiovascular risk factors: An umbrella review of meta-analyses of randomized controlled trials

“…The dosages and durations of dietary fiber intervention ranged from 3 g/day to 30 g/day (except for one study, which used guar gum at 15 mg/day, and another study that used brown rice at 225 g/d), and 4 to 13 weeks, respectively. Twenty-two meta-analyses were performed in China ( 23 , 25 – 27 , 29 – 31 , 35 – 37 , 42 , 43 , 45 , 49 , 51 , 53 – 56 , 69 – 71 ), six in Iran ( 24 , 32 – 34 , 38 , 40 ), four in the UK ( 13 , 39 , 41 , 57 ), one in Australia ( 14 ), eight in Canada ( 44 , 46 , 47 , 50 , 52 , 58 , 62 , 72 ), five in the USA ( 48 , 60 , 65 , 67 , 68 ), one in Brazil ( 59 ), one in Ireland ( 61 ), one in South Africa ( 63 ), one in Italy ( 64 ), one in the Netherlands ( 66 ), and one in Malaysia ( 28 ).…”

Bioactive Compounds and Their Effect on Blood Pressure—A Review

“…It revealed a reduction of 2.04 mmHg in SBP (95% confidence interval, p < 0.001). The analysis also revealed that the effect of psyllium was stronger in participants with a higher baseline blood pressure [ 63 ].…”