Fructose consumption and metabolic hypertension in rats: a systematic review and meta-analysis

Hypertension is a growing cardiovascular risk, increasingly linked to dietary changes. This meta-analysis examines the impact of dietary fructose on hypertension by evaluating the mean difference in systolic blood pressure (SBP) in rats, considering fructose intake levels (10-30% in solution; 60-75% in diet) and exposure duration (<8 weeks, 8 weeks and >8 weeks).

A comprehensive search across Cochrane, Web of Science, Scopus and Ovid (MEDLINE, Embase, AMED) databases identified relevant reports published until December 2022. The meta-analysis, conducted using Review Manager 5.4 software, included a total of 24 studies, with quantitative data analysed through a random-effects model.

Fructose treatment significantly raised SBP in rats by 31.05 mmHg (95% CI [24.36-37.74], P < 0.00001), with an I ² value of 100%, indicating high heterogeneity. Subgroup analysis showed SBP increases of 28.50 mmHg (95% CI [15.25-41.75]) for 10-30% w/v fructose solution and 33.80 mmHg (95% CI [28.27-39.33]) for 60-75% w/v fructose diet, reinforcing a strong link to hypertension and suggesting a dose-dependent effect. Additionally, analysis based on fructose administration duration confirmed a significant SBP increase, underscoring its impact.

Animal studies suggest that fructose intake may contribute to elevated SBP, potentially increasing the risk of hypertension. While trends were observed across various doses and exposure durations, not all findings reached statistical significance. These observations highlight the importance of further research into the long-term effects of fructose on human blood pressure and their relevance to dietary guidelines and public health policies.