Does arginine supplementation cause hypotension (low blood pressure)?

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Last updated: May 27, 2025View editorial policy

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From the Guidelines

Arginine supplements can cause a decrease in blood pressure, as evidenced by a study published by Nagaya et al, which found a 9% decrease in mean pulmonary arterial pressure and a modest decrease in mean systemic arterial pressure with oral L-arginine supplementation 1.

Key Findings

  • The study found that oral supplementation of L-arginine (0.5 g/10 kg body weight) significantly increased plasma L-citrulline, indicating enhancement of NO production 1.
  • Supplemental L-arginine produced a 9% decrease in mean pulmonary arterial pressure (mPAP) and a 16% decrease in pulmonary vascular resistance (PVR) 1.
  • L-arginine modestly decreased mean systemic arterial pressure (92 ± 4 to 87 ± 3 mm Hg, p < 0.05) 1.

Mechanism of Action

  • Arginine works by potentially increasing nitric oxide production in the body, which helps blood vessels relax and dilate, improving blood flow and potentially lowering blood pressure 1.

Important Considerations

  • The effect of arginine supplements on blood pressure may not be consistent across all populations, and more research is needed to fully understand its effects 1.
  • Potential drawbacks of arginine supplementation may include an increase in the concentration of polyamines, which are proproliferative 1.
  • Arginine supplements may interact with certain medications, including blood pressure medications, erectile dysfunction drugs, and blood thinners, so consulting with a healthcare provider before starting supplementation is important.

From the Research

Arginine Supplementation and Blood Pressure

  • The effect of arginine supplementation on blood pressure has been studied in several trials, with most showing a decrease in blood pressure 2, 3, 4, 5.
  • A meta-analysis of 11 randomized, double-blind, placebo-controlled trials found that oral L-arginine supplementation significantly lowered systolic blood pressure by 5.39 mmHg and diastolic blood pressure by 2.66 mmHg 2.
  • Another study found that L-arginine supplementation lowered blood pressure by 5.39/2.66 mmHg, which is comparable to the effects of diet changes and exercise implementation 3.
  • A single-blind, controlled, crossover dietary intervention study found that L-arginine-rich diets decreased blood pressure in healthy volunteers, with a decrease in systolic blood pressure of 6.2 mmHg and diastolic blood pressure of 5.0-6.8 mmHg 4.
  • An umbrella review of meta-analyses found that L-arginine supplementation reduced systolic and diastolic blood pressure in hypertensive adults by 2.2-5.4 mmHg and 2.7-3.1 mmHg, respectively 5.

Mechanism of Action

  • The mechanism by which arginine supplementation lowers blood pressure is thought to be related to its role as a substrate for nitric oxide synthase, which produces nitric oxide, a vasodilator 6, 3.
  • The "L-arginine paradox" refers to the phenomenon where elevated plasma arginine concentrations increase endogenous nitric oxide production, despite normal plasma arginine concentrations exceeding the Michaelis constant of nitric oxide synthase 3.

Study Limitations

  • Some studies had limited sample sizes and statistical power, which may have affected the results 2, 5.
  • There was statistically significant heterogeneity observed in some of the meta-analyses, which may have impacted the accuracy of the results 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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