Potential of favorable effects of probiotics fermented milk supplementation on blood pressure: a systematic review and meta-analysis

The effect of probiotics fermented milk (PFM) supplementation on blood pressure (BP) is conflicting. This review aimed to summarize available evidence from human trials evaluating the effects of PFM supplementation on BP in adults. Online databases, including PubMed, Scopus, EMBASE, and Cochran were searched for relevant studies published up to December 2019, using relevant keywords. All randomized controlled trials (RCTs) investigating the PFM supplementation on BP were included. The quality of this study was evaluated using the Cochrane Collaboration Risk of Bias Assessment tool. Meta-analysis was done using the random-effects model. Heterogeneity and publication bias were assessed in selected studies. Sensitivity analysis and subgroup analysis were conducted to examine potential heterogeneity. Meta-analysis of 24 (31 arms) randomized placebo-controlled trials involving 2102 participants showed that PFM supplementation did not change in systolic BP (SBP) (WMD: −2.17 mmHg; 95% CI: −4.5, 0.16, P = .068) as well in diastolic BP (DBP) (WMD: −1.04, 95% CI: −2.51 to 0.44, P = .167) subgroup analyses based on baseline SBP and DBP, duration of intervention, baseline BMI, mean age, and health status suggested a large significant decreasing effect on systolic and diastolic BP in prehypertensive (pre-HTN) and hypertensive (HTN) subset (P < .05). Our study concludes that PFM supplementation may have beneficial effects on systolic and diastolic BP in pre-HTN and HTN subjects. Future investigations on the clinical efficacy and safety of PFM supplementation are warranted to elucidate these beneficial effects.