Skip to main content Accessibility help

Monounsaturated fatty acids, olive oil and blood pressure: epidemiological, clinical and experimental evidence

  • Álvaro Alonso (a1) (a2), Valentina Ruiz-Gutierrez (a3) and Miguel Ángel Martínez-González (a1)

Diet has an important role in the prevention and treatment of hypertension. In early epidemiological studies, conducted mainly in the USA, monounsaturated fatty acids showed a deleterious association with blood pressure or no relationship at all. However, more recent studies, conducted in Mediterranean countries, have shed new light on this issue. In the present review we summarise the main results of epidemiological studies and feeding trials, and explain the possible mechanisms through which monounsaturated fatty acids, and specifically olive oil as the major dietary source of this type of fat in Mediterranean countries, could exert a favourable effect on blood pressure.

    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Monounsaturated fatty acids, olive oil and blood pressure: epidemiological, clinical and experimental evidence
      Available formats
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Monounsaturated fatty acids, olive oil and blood pressure: epidemiological, clinical and experimental evidence
      Available formats
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Monounsaturated fatty acids, olive oil and blood pressure: epidemiological, clinical and experimental evidence
      Available formats
Corresponding author
*Corresponding author: Email
Hide All
1Hermansen, K. Diet, blood pressure and hypertension. British Journal of Nutrition 2000; 83: S113–9.
2Reddy, KS, Katan, MB. Diet, nutrition and the prevention of hypertension and cardiovascular diseases. Public Health Nutrition 2004; 7: 167–86.
3Whelton, PK, He, J, Appel, LJ, Cutler, JA, Havas, S, Kotchen, TA, et al. ; National High Blood Pressure Education Program Coordinating Committee. Primary prevention of hypertension: clinical and public health advisory from the National High Blood Pressure Education Program. Journal of the American Medical Association 2002; 288: 1882–8.
4Appel, LJ, Moore, TJ, Obarzanek, E, Vollmer, WM, Svetkey, LP, Sacks, FM, et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. New England Journal of Medicine 1997; 336: 1117–24.
5Martínez-González, MA, Sánchez-Villegas, A. The emerging role of Mediterranean diets in cardiovascular epidemiology: monounsaturated fats, olive oil, red wine or the whole pattern? European Journal of Epidemiology 2004; 19: 913.
6Psaltopoulou, T, Naska, A, Orfanos, P, Trichopoulos, D, Mountokalakis, T, Trichopoulou, A. Olive oil, the Mediterranean diet, and arterial blood pressure: the Greek European Prospective Investigation into Cancer and Nutrition (EPIC) study. American Journal of Clinical Nutrtion 2004; 80: 1012–8.
7Moreiras, O, Carbajal, A, Cabrera, L, Cuadrado, C. Tablas de Composición de Alimentos, 7th ed. Madrid: Pirámide, 2003.
8US Department of Agriculture, Agricultural Research Service. USDA National Nutrient Database for Standard Reference, Release 17 [online]. Available at Accessed 21 05 2005.
9Martínez-Force, E, Garcés, R. New varieties with modified fatty acid composition in the oil. Trends in Agronomy 1999; 2: 1321.
10Hulshof, KFAM, van Erp-Baart, MA, Anttolainen, M, Becker, W, Church, SM, Couet, C, et al. Intake of fatty acids in Western Europe with emphasis on trans fatty acids: the TRANSFAIR study. European Journal of Clinical Nutrition 1999; 53: 143–57.
11Nicklas, TA, Hampl, JS, Taylor, CA, Thompson, VJ, Heird, WC. Monounsaturated fatty acid intake by children and adults: temporal trends and demographic differences. Nutrition Reviews 2004; 62: 132–41.
12Ros, E. Dietary cis-monounsaturated fatty acids and metabolic control in type 2 diabetes. American Journal of Clinical Nutrition 2003; 78: 617S–25S.
13Witteman, JCM, Willett, WC, Stampfer, MJ, Colditz, GA, Sacks, FM, Speizer, FE, et al. prospective study of nutritional factors and hypertension among US women. Circulation 1989; 80: 1320–7.
14Ascherio, A, Hennekens, CH, Willett, WC, Sacks, F, Rosner, B, Manson, J, et al. Prospective study of nutritional factors, blood pressure, and hypertension among US women. Hypertension 1996; 27: 1065–72.
15Ascherio, A, Rimm, EB, Giovannucci, EL, Colditz, GA, Rosner, B, Willett, WC, et al. A prospective study of nutritional factors and hypertension among US men. Circulation 1992; 86: 1475–84.
16Stamler, J, Liu, K, Ruth, KJ, Pryer, J, Greenland, P. Eight-year blood pressure change in middle-aged men: relationship to multiple nutrients. Hypertension 2002; 39: 1000–6.
17Stamler, J, Caggiula, A, Grandits, GA, Kjelsberg, M, Cutler, JA. Relationship to blood pressure of combinations of dietary macronutrients: findings of the Multiple Risk Factor Intervention Trial (MRFIT). Circulation 1996; 94: 2417–23.
18Williams, PT, Fortmann, SP, Terry, RB, Garay, SC, Vranizan, KM, Ellsworth, N, et al. Associations of dietary fat, regional adiposity, and blood pressure in men. Journal of the American Medical Association 1987; 257: 3251–6.
19Trevisan, M, Krogh, V, Freudenheim, J, Blake, A, Muti, P, Panico, S, et al. Consumption of olive oil, butter, and vegetable oils and coronary heart disease risk factors. The Research Group ATS-RF2 of the Italian National Research Council. Journal of the American Medical Association 1990; 263: 688–92.
20Alonso, A, Martínez-González, MA. Olive oil consumption and reduced incidence of hypertension: the SUN Study. Lipids 2004; 39: 1233–8.
21Hajjar, I, Kotchen, T. Regional variations of blood pressure in the United States are associated with regional variations in dietary intakes: The NHANES-III data. Journal of Nutrition 2003; 133: 211–4.
22Martínez-González, MA, Sánchez-Villegas, A, de Irala-Estévez, J, Martí, A, Martínez, JA. Mediterranean diet and stroke: objectives and design of the SUN Project. Nutritional Neuroscience 2002; 5: 6573.
23Alonso, A, de, la, Fuente, C, Martín-Arnau, AM, de Irala, J, Martínez, JA, Martínez-González, MA. Fruit and vegetable consumption is inversely associated with blood pressure in a Mediterranean population with a high vegetable-fat intake: the Seguimiento Universidad de Navarra (SUN) Study. British Journal of Nutrition 2004; 92: 311–9.
24Alonso, A, Beunza, JJ, Delgado-Rodrguez, M, Martínez-Goxaález, MA. Validation of self reported diagnosis of hypertension in a cohort of university graduates in Spain. BMC Public Health 1988; 5: 94.
25Mensink, RP, Janssen, MC, Katan, MB. Effect on blood pressure of two diets differing in total fats but not in saturated and polyunsaturated fatty acids in healthy volunteers. American Journal of Clinical Nutrition 1988; 47: 976–80.
26Rasmussen, OW, Thomsen, C, Hansen, KW, Vesterlund, M, Winther, E, Hermansen, K. Effects on blood pressure, glucose, and lipid levels of a high-monounsaturated fat diet compared with a high-carbohydrate diet in NIDDM subjects. Diabetes Care 1993; 16: 1565–71.
27Passfall, J, Philipp, T, Woermann, F, Quass, P, Thiede, M, Haller, H. Different effects of eicosapentaenoic acid and olive oil on blood pressure, intracellular free platelet calcium, and plasma lipids in patients with essential hypertension. Clinical Investigation 1993; 71: 628–33.
28Thomsen, C, Rasmussen, OW, Hansen, KW, Vesterlund, M, Hermansen, K. Comparison of the effects on the diurnal blood pressure, glucose, and lipid levels of a diet rich in monounsaturated fatty acids with a diet rich in polyunsaturated fatty acids in type 2 diabetic subjects. Diabetic Medicine 1995; 12: 600–6.
29Ruiz-Gutiérrez, V, Muriana, FJ, Guerrero, A, Cert, AM, Villar, J. Plasma lipids, erythrocyte membrane lipids and blood pressure of hypertensive women after ingestion of dietary oleic acid from two different sources. Journal of Hypertension 1996; 14: 1483–90.
30Lahoz, C, Alonso, R, Ordovas, JM, López-Farre, A, de Oya, M, Mata, P. Effects of dietary fat saturation on eicosanoid production, platelet aggregation and blood pressure. European Journal of Clinical Investigation 1997; 27: 780–7.
31Salas, J, López Miranda, J, Jansen, S, Zambrana, JL, Castro, P, Paniagua, JA, et al. La dieta rica en grasa monoinsaturada modifica de forma beneficiosa el metabolismo de los hidratos de carbono y la presión arterial. Medicina Clinica 1999; 113: 765–9.
32Ferrara, LA, Raimondi, AS, d'Episcopo, L, Guida, L, Dello Russo, A, Marotta, T. Olive oil and reduced need for antihypertensive medications. Archives of Internal Medicine 2000; 160 837–42.
33Appel, LJ, Sacks, FM, Carey, VJ, Obarzanek, E, Swain, JF, Miller, ER III, et al. Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids. Results of the OmniHeart Randomized Trial. Journal of the American Medical Association 2005; 294: 2455–64.
34Lauszus, FF, Rasmussen, OW, Henriksen, JE, Klebe, JG, Jensen, L, Lauszus, KS et al. . Effect of a high monounsaturated fatty acid diet on blood pressure and glucose metabolism in women with gestational diabetes mellitus. Eurpean Journal of Clinical Nutrition 2001; 55: 436–43.
35Perona, JS, Cañizares, J, Montero, E, Sánchez-Dóminguez, JM, Catalá, A, Ruiz-Gutiérrez, V. Virgin olive oil reduces blood pressure in hypertensive elderly subjects. Clinical Nutrition 2004; 23: 1113–21.
36Strazzullo, P, Ferro-Luzzi, A, Siani, A, Scaccini, C, Sette, S, Catasta, G et al. . Changing the Mediterranean diet: effects on blood pressure. Journal of Hypertension 1986; 4: 407–12.
37Singer, P, Jaeger, W, Berger, I, Barleben, H, Wirth, M, Richter-Heinrich, E, et al. Effects of dietary oleic, linoleic and α-linolenic acids on blood pressure, serum lipids, lipoproteins and the formulation of eicosanoid precursors in patients with mild essential hypertension. Journal of Human Hypertension 1990; 4: 227–33.
38Naito, Y, Nagata, T, Takano, Y, Nagatsu, T, Ohara, N. Rapeseed oil ingestion and exacerbation of hypertension-related conditions in stroke prone spontaneously hypertensive rats. Toxicology 2003; 187: 205–16.
39Aguila, MB, Sa Silva, SP, Pinheiro, AR, Mandarim-de-Lacerda, CA. Effects of long-term intake of edible oils on hypertension and myocardial and aortic remodelling in spontaneously hypertensive rats. Journal of Hypertension 2004; 22: 921–9.
40Huang, MZ, Watanabe, S, Kobayashi, T, Nagatsu, A, Sakakibara, J, Okuyama, H. Unusual effect of some vegetable oils on the survival time of stroke-prone spontaneously hypertensive rats. Lipids 1997; 32: 745–51.
41Ratnayake, WM, Plouffe, L, Hollywood, R, L'Abbe, MR, Hidiroglou, N, Sarwar, G, et al. Influence of sources of dietary oils on the life span of stroke-prone spontaneously hypertensive rats. Lipids 2000; 35: 409–20.
42Mutanen, M, Kleemola, P, Valsta, LM, Mensink, RP, Rasanen, L. Lack of effect on blood pressure by polyunsaturated and monounsaturated fat diets. European Journal of Clinical Nutrition 1992; 46: 16.
43Pagnan, A, Corrocher, R, Ambrosio, GB, Ferrari, S, Guarini, P, Piccolo, D, et al. Effects of an olive oil-rich diet on erythrocyte membrane lipid composition and cation transport systems. Clinical Science 1989; 76: 8793.
44Corrocher, R, Pagnan, A, Ambrosio, GB, Ferrari, S, Olivieri, O, Guarini, P, et al. Effects induced by olive oil-rich diet on erythrocytes membrane lipids and sodium–potassium transports in postmenopausal hypertensive women. Journal of Endocrinological Investigation 1992; 15: 369–76.
45Alemany, R, Terés, S, Baamonde, C, Benet, M, Vögler, O, Escribá, PV. 2–Hydroxyoleic acid: a new hypotensive molecule. Hypertension 2004; 43: 249–54.
46Soriguer, F, Rojo-Martínez, G, Dobarganes, MC, Garcia Almeida, JM, Esteva, I, Beltran, M, et al. Hypertension is related to the degradation of dietary frying oils. American Journal of Clinical Nutrition 2003; 78: 1092–7.
47de la Puerta, R, Ruiz-Gutiérrez, V, Hoult, JRS, Inhibition of leukocyte 5-lipoxygenase by phenolics from virgin olive oil. Biochemical Pharmacology 1999; 57: 445–9.
48Cai, H, Harrison, DG. Endothelial dysfunction in cardiovascular diseases: the role of oxidant stress. Circulation Research 2000; 87: 840–4.
49Herrera, MD, Pérez-Guerrero, C, Marhuenda, E, Ruiz-Gutiérrez, V. Effects of dietary oleic-rich oils (virgin olive and high-oleic-acid sunflower) on vascular reactivity in Wistar–Kyoto and spontaneously hypertensive rats. British Journal of Nutrition 2001; 86: 349–57.
50Vogel, RA, Corretti, MC, Plotnick, GD, The postprandial effect of components of the Mediterranean diet on endothelial function. Journal of the American College of Cardiology 2000; 36: 1455–60.
51Ong, PJL, Dean, TS, Hayward, CS, Della Monica, PL, Sanders, TAB, Collins, P. Effect of fat and carbohydrate consumption on endothelial function. Lancet 1999; 354: 2134.
52Williams, MJA, Sutherland, WHF, McCormick, MP, Yeoman, D, de, Jong, SA Walker, RJ. Normal endothelial function after meals rich in olive oil or safflower oil previously used for deep frying. Nutrition, Metabolism, and Cardiovascular Diseases 2001; 11: 147–52.
53West, SG, Hecker, KD, Mustad, VA, Nicholson, S, Schoemer, SL, Wagner, P. Acute effects of monounsaturated fatty acids with and without omega–3 fatty acids on vascular reactivity in individuals with type 2 diabetes. Diabetologia 2005; 48: 113–22.
54Fuentes, F, López-Miranda, J, Sanchez, E, Sanchez, F, Paez, J, Paz-Rojas, E et al. . Mediterranean and low-fat diets improve endothelial function in hypercholesterolemic men. Annals of Internal Medicine 2001; 134: 1115–9.
55Ryan, M, McInerney, D, Owens, D, Collins, P, Johnson, A, Tomkin, GH. Diabetes and the Mediterranean diet: a beneficial effect of oleic acid on insulin sensitivity, adipocyte glucose transport and endothelium-dependent vasoreactivity. Quarterly Journal of Medicine 2000; 93: 8591.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed