How Can Arginine Help High Blood Pressure?

Hypertension is the medical term for high blood pressure that stays high over time. Primary hypertension (also called essential hypertension) is the most common type, affecting about 90% of people with high blood pressure. If your blood pressure stays too high, you are much more likely to have serious health problems like strokes, heart attacks, kidney disease, and vision loss [1].

What is Arginine?

Arginine is an important amino acid that helps the body carry out key functions. Normally, the body makes its own arginine, but during stress or illness, it may not make enough [2]. That’s why it’s important to get arginine from food. Since arginine is an amino acid (a building block of protein), it is found in high-protein foods like turkey, chicken, and tofu [3].

Why is Arginine important in controlling blood pressure?

People with primary hypertension often have blood vessels that don’t work as they should. Normally, blood vessels widen or narrow to control blood pressure. But in people with hypertension, the blood vessels are stiff and narrow, so blood pressure stays high. This happens because blood vessels need a substance called nitric oxide to work properly, and people with hypertension have low levels of it [4]. The body needs arginine to make nitric oxide, which is why experts first suggested that arginine supplements might help with hypertension.

What is the history of arginine in blood pressure research?

Arginine was first discovered in 1886 [5]. Scientists first wrote about its importance for blood vessels in 1988 [6]. The first study on whether arginine supplements could help blood vessels work better was published in 1991 [7].

What evidence is there that arginine helps with high blood pressure?

Many studies on both animals and humans with high blood pressure suggest that arginine can help [4]. A key study from 2022 reviewed 22 different trials and found that arginine can lower blood pressure[8].

However, not all studies agree. Some researchers question whether arginine is helpful because, in healthy people, nitric oxide levels in the blood and urine do not always increase as expected. Also, arginine is already present in the blood at high levels, so taking more might not boost nitric oxide production [4].

There are several possible explanations for these findings:

• Most of these studies were done on healthy people, not those with heart or blood vessel diseases, so the results may not apply to those with hypertension.

• Taking arginine can decrease the level of substances that block the body from making nitric oxide.

• Nitric oxide levels may still increase, but instead of appearing in the blood or urine, they may be in deep tissues.

• Arginine may work in a more complex way, involving other hormones and enzymes that help control blood vessels. [4 , 8]

What could be a safe dose?

Studies suggest that taking up to 20 grams of arginine per day is likely safe, though these studies have only been done on small groups of people [9]. One study with fewer than 50 people found that taking up to 30 grams daily for three months caused no harm [10]. However, taking 13 grams taken at once may cause diarrhoea [10B]. Another study on 66 kidney patients found that taking 9 grams per day for three years also had no negative effects [11].

What could be the best regime?

There is no clear study on the best way to take arginine, but it may be best to take it two or three times a day [12]. This is because arginine levels in the blood peak about 1 to 1.5 hours after taking it and usually return to near normal within 8 hours [13 , 14].

What could be the best course length?

The best course length is likely less than 2–3 months. Animal studies suggest that taking arginine for 16 weeks may harm the kidneys [15]. Also, its blood pressure benefits may stop after 24 days, possibly because the body starts breaking it down more efficiently [8 , 15].

What could be the best form?

Arginine supplements are usually labeled ‘L-arginine.’ The ‘L’ refers to its 3D structure [12]. L-arginine is the natural form found in the body and is important for blood vessels, so it has been studied more. The opposite form, D-arginine, is less common and mainly affects the brain [16].

Research suggests that taking citrulline with arginine may help by increasing arginine levels in the blood by slowing its breakdown in the liver [17 , 18].

When should arginine be avoided?

• Cancer: People with cancer may need to avoid arginine, as it could increase tumour growth. More research is needed to confirm this [9].

• Recent Heart Attack: Taking arginine soon after a heart attack may increase the risk of serious complications, including death. It should be avoided.

• Upcoming Surgery: Arginine should be stopped at least 2 weeks before surgery, as it may make it harder to control blood pressure during the procedure. [19]

When should you be cautious?

• Pregnancy, breast feeding and children: There isn’t enough research to confirm arginine is safe during pregnancy, breastfeeding, or in children, so it should be used with caution.

• Kidney disease: People with kidney disease should be careful as taking arginine may raise potassium levels in the blood, which can cause an irregular or fast heartbeat.

• Guanidinoacetate methyltransferase deficiency (GAMT): This rare genetic condition causes a buildup of a toxic substance when arginine is taken. People with GAMT should avoid arginine. [19]

What medications might interact with arginine?

• Blood Pressure Medication: Arginine may lower blood pressure, so taking it with blood pressure medications (like ramipril, lisinopril, candesartan, losartan, amlodipine, and others) could lower it too much. Viagra (sildenafil) may have a similar effect.

• Certain Water Tablets (Potassium-Sparing Diuretics): Arginine may interact with water tablets like spironolactone, raising potassium levels and potentially causing an irregular or fast heartbeat.

• Diabetes Medication: Arginine may make insulin work better, which could lower blood sugar too much if you’re also taking diabetes medication.

• Blood Thinners: Arginine may make blood thinners (like warfarin, apixaban, rivaroxaban, aspirin, clopidogrel) more effective, increasing the risk of bleeding. [19]

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Disclaimer and advice going forward

The information above is for education and awareness only and is not a substitute for professional medical advice. The information above does not cover all possible interactions, adverse effects, precautions and uses. Always consult a qualified healthcare professional before taking any supplement, herb or therapy or changing your medications.

For personalised naturopathic advice and assessment of your health situation, you can book a free video call with Dr. Ramiz Ahmed-Man to enquire further. 

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References

1.    Feather A, Randall D, Waterhouse M, editors. Hypertension. In: Kumar and Clark’s Clinical Medicine. 10th ed. Elsevier; 2020. p. 1133-1145.

2.    Tong BC, Barbul A. Cellular and physiological effects of arginine. Mini Rev Med Chem. 2004 Oct;4(8):823-32. doi: 10.2174/1389557043403305. PMID: 15544543. https://pubmed.ncbi.nlm.nih.gov/15544543/

3.    MyFoodData. Nutrition facts search tool. MyFoodData.com. [cited 2025 Mar 19]. Available from: https://tools.myfooddata.com/nutrition-facts

4.    Gambardella J, Khondkar W, Morelli MB, Wang X, Santulli G, Trimarco V. Arginine and Endothelial Function. Biomedicines. 2020 Aug 6;8(8):277. doi: 10.3390/biomedicines8080277. PMID: 32781796; PMCID: PMC7460461. https://pubmed.ncbi.nlm.nih.gov/12481979/

5.    American Chemical Society. L-Arginine – Molecule of the Week. ACS.org. [cited 2025 Mar 19]. Available from: https://www.acs.org/molecule-of-the-week/archive/a/l-arginine.html

6.    Palmer RM, Ashton DS, Moncada S. Vascular endothelial cells synthesize nitric oxide from L-arginine. Nature. 1988 Jun 16;333(6174):664-6. doi: 10.1038/333664a0. PMID: 3131684. https://pubmed.ncbi.nlm.nih.gov/3131684/

7.    Drexler H, Zeiher AM, Meinzer K, Just H. Correction of endothelial dysfunction in coronary microcirculation of hypercholesterolaemic patients by L-arginine. Lancet. 1991 Dec 21-28;338(8782-8783):1546-50. doi: 10.1016/0140-6736(91)92372-9. PMID: 1683971. https://pubmed.ncbi.nlm.nih.gov/1683971/

8.    Shiraseb F, Asbaghi O, Bagheri R, Wong A, Figueroa A, Mirzaei K. Effect of l-Arginine Supplementation on Blood Pressure in Adults: A Systematic Review and Dose-Response Meta-analysis of Randomized Clinical Trials. Adv Nutr. 2022 Aug 1;13(4):1226-1242. doi: 10.1093/advances/nmab155. PMID: 34967840; PMCID: PMC9340976. https://pubmed.ncbi.nlm.nih.gov/34967840/

9.    McNeal CJ, Meininger CJ, Reddy D, Wilborn CD, Wu G. Safety and Effectiveness of Arginine in Adults. J Nutr. 2016 Dec;146(12):2587S-2593S. doi: 10.3945/jn.116.234740. Epub 2016 Nov 9. PMID: 27934649. https://pubmed.ncbi.nlm.nih.gov/27934649/

10. McNeal CJ, Meininger CJ, Wilborn CD, Tekwe CD, Wu G. Safety of dietary supplementation with arginine in adult humans. Amino Acids. 2018 Sep;50(9):1215-1229. doi: 10.1007/s00726-018-2594-7. Epub 2018 Jun 1. PMID: 29858688. https://pubmed.ncbi.nlm.nih.gov/29858688/

10B. Allerton TD, Proctor DN, Stephens JM, Dugas TR, Spielmann G, Irving BA. l-Citrulline Supplementation: Impact on Cardiometabolic Health. Nutrients. 2018 Jul 19;10(7):921. doi: 10.3390/nu10070921. PMID: 30029482; PMCID: PMC6073798 https://pubmed.ncbi.nlm.nih.gov/30029482/

11. Alexander JW, Metze TJ, McIntosh MJ, Goodman HR, First MR, Munda R, Cardi MA, Austin JN, Goel S, Safdar S, Greenberg N, Chen X, Woodle ES. The influence of immunomodulatory diets on transplant success and complications. Transplantation. 2005 Feb 27;79(4):460-5. doi: 10.1097/01.tp.0000148802.04879.27. PMID: 15729173. https://pubmed.ncbi.nlm.nih.gov/15729173/

12. Cleveland Clinic. L-Arginine: Uses, dosage, and side effects. ClevelandClinic.org. [cited 2025 Mar 19]. Available from: https://my.clevelandclinic.org/health/drugs/22536-l-arginine

13. Mariotti F, Petzke KJ, Bonnet D, Szezepanski I, Bos C, Huneau JF, Fouillet H. Kinetics of the utilization of dietary arginine for nitric oxide and urea synthesis: insight into the arginine-nitric oxide metabolic system in humans. Am J Clin Nutr. 2013 May;97(5):972-9. doi: 10.3945/ajcn.112.048025. Epub 2013 Mar 27. PMID: 23535108. https://pubmed.ncbi.nlm.nih.gov/23535108/

14. Tangphao O, Grossmann M, Chalon S, Hoffman BB, Blaschke TF. Pharmacokinetics of intravenous and oral L-arginine in normal volunteers. Br J Clin Pharmacol. 1999 Mar;47(3):261-6. doi: 10.1046/j.1365-2125.1999.00883.x. PMID: 10215749; PMCID: PMC2014227. https://pubmed.ncbi.nlm.nih.gov/10215749/

15. Huang J, Ladeiras D, Yu Y, Ming XF, Yang Z. Detrimental Effects of Chronic L-Arginine Rich Food on Aging Kidney. Front Pharmacol. 2021 Jan 19;11:582155. doi: 10.3389/fphar.2020.582155. PMID: 33542686; PMCID: PMC7851093. https://pmc.ncbi.nlm.nih.gov/articles/PMC7851093/

16. Navarro E, Alonso SJ, Martín FA, Castellano MA. Toxicological and pharmacological effects of D-arginine. Basic Clin Pharmacol Toxicol. 2005 Sep;97(3):149-54. doi: 10.1111/j.1742-7843.2005.pto_973110.x. PMID: 16128908. https://pubmed.ncbi.nlm.nih.gov/16128908/

17. Rashid J, Kumar SS, Job KM, Liu X, Fike CD, Sherwin CMT. Therapeutic Potential of Citrulline as an Arginine Supplement: A Clinical Pharmacology Review. Paediatr Drugs. 2020 Jun;22(3):279-293. doi: 10.1007/s40272-020-00384-5. PMID: 32140997; PMCID: PMC7274894. https://pubmed.ncbi.nlm.nih.gov/32140997

18. Suzuki T, Morita M, Hayashi T, Kamimura A. The effects on plasma L-arginine levels of combined oral L-citrulline and L-arginine supplementation in healthy males. Biosci Biotechnol Biochem. 2017 Feb;81(2):372-375. doi: 10.1080/09168451.2016.1230007. Epub 2016 Sep 26. PMID: 27667025. https://pubmed.ncbi.nlm.nih.gov/27667025/

19. WebMD. L-Arginine: Uses, side effects, and more. WebMD.com. [cited 2025 Mar 19]. Available from: https://www.webmd.com/vitamins/ai/ingredientmono-875/l-arginine