Does NAD Raise Blood Pressure? What the Latest Research Shows

October 11, 2025 •

5 min read

As we age, our body's levels of nicotinamide adenine dinucleotide (NAD+) naturally decline. For those considering supplementation, a critical question often arises: Does NAD raise blood pressure? The available evidence from clinical studies suggests a more complex, and often opposite, effect.

Quick Summary

Studies show NAD+ precursor supplementation, like NMN and NR, generally does not raise blood pressure and may actually help lower it in specific populations. The effect is tied to improving vascular function and reducing arterial stiffness. Caution is advised for individuals on blood pressure medication due to potential additive effects.

Key Points

NAD+ decline linked to aging: Lower NAD+ levels with age are associated with vascular aging and increased cardiovascular disease risk.
NAD+ boosters may lower blood pressure: Studies on precursors like NMN and NR show a potential to reduce blood pressure, not raise it, especially in those with existing hypertension.
Mechanism involves improved vascular function: The beneficial effect on blood pressure is linked to enhanced endothelial function, reduced arterial stiffness, and lowered inflammation.
NMN studies show promise: In clinical trials, NMN has been shown to lower diastolic blood pressure in overweight adults and blood pressure in hypertensive patients.
Consider medication interactions: Individuals on blood pressure-lowering medications should consult a doctor, as NAD+ supplementation could enhance their effects and cause hypotension.
General side effects are usually mild: While serious side effects are rare, typical mild reactions can include flushing, nausea, or headaches, particularly with IV administration.
More research needed for long-term effects: While short-term safety seems favorable, larger and longer clinical trials are necessary to fully understand the long-term impact of NAD+ supplementation.

What is NAD+ and Why Does it Matter for Cardiovascular Health?

Nicotinamide adenine dinucleotide (NAD+) is a vital coenzyme present in every cell of the body. It plays a central role in energy metabolism, DNA repair, and gene expression. The decline of NAD+ levels with age has been linked to numerous age-related health issues, including cardiovascular decline. Researchers believe that restoring NAD+ to more youthful levels may offer protective effects against such conditions.

For the cardiovascular system, NAD+ is crucial for maintaining the health of blood vessels, or vascular function. It is involved in:

Reducing oxidative stress: The build-up of damaging free radicals can harm blood vessel walls. NAD+ helps boost the body's antioxidant defenses.
Enhancing endothelial function: The endothelium is the inner lining of blood vessels. NAD+ supports its proper function, which is critical for regulating blood flow and pressure.
Decreasing arterial stiffness: Stiffening of the large arteries with age is a primary driver of elevated systolic blood pressure. NAD+ precursors have been shown to reduce this stiffness.

The Effect of NAD Precursors on Blood Pressure

When people ask, "Does NAD raise blood pressure?", they are typically referring to supplementation with NAD+ precursors, such as nicotinamide mononucleotide (NMN) and nicotinamide riboside (NR), which are used to boost the body's NAD+ levels. The collective scientific evidence points toward these precursors having a neutral-to-beneficial effect on blood pressure, rather than increasing it.

NMN and Hypertension

Several human and animal studies have specifically investigated the link between NMN and blood pressure. A 2023 trial in hypertensive patients, for example, found that 800 mg of oral NMN daily for six weeks significantly lowered blood pressure. The study observed that individuals with high blood pressure had lower baseline NAD+ levels and higher levels of the NAD+-consuming enzyme CD38. Supplementation not only restored NAD+ but also improved vascular function. Another study involving overweight or obese adults showed that 2,000 mg of NMN per day significantly reduced diastolic blood pressure.

Nicotinamide Riboside (NR) and Blood Pressure

Similar to NMN, Nicotinamide Riboside (NR) has been studied for its cardiovascular effects. A pilot study published in Nature Communications in 2018 involved healthy, middle-aged and older adults with slightly elevated blood pressure. Participants taking 1000 mg of NR daily for six weeks experienced a modest but significant reduction in systolic blood pressure and arterial stiffness, without serious side effects.

Potential Interactions and Side Effects to Consider

While the main concern that NAD raises blood pressure appears unfounded, it is essential to consider the full safety profile and potential drug interactions. High doses or certain health conditions can influence the effects of NAD+ boosters. One potential interaction is with blood pressure-lowering medication, where supplementing with NAD+ could cause blood pressure to drop too low. This highlights the necessity of medical supervision, especially for individuals with existing hypertension.

Other common side effects

Flushing, headaches, and nausea (particularly with intravenous NAD+ therapy).
Gastrointestinal issues, fatigue, and muscle cramps.

Comparison Table: NMN vs. NR and Blood Pressure


Feature	Nicotinamide Mononucleotide (NMN)	Nicotinamide Riboside (NR)
Research on BP	Multiple human trials suggest NMN may help lower elevated blood pressure, especially diastolic, and improve vascular function in hypertensive and overweight adults.	Initial studies in middle-aged and older adults with above-normal blood pressure showed a modest reduction in systolic blood pressure and arterial stiffness.
Mechanism	Boosts NAD+ levels, which can suppress CD38—a key enzyme that degrades NAD+ and is elevated in hypertension.	Raises NAD+ bioavailability, improving mitochondrial function and potentially activating Sirtuin enzymes involved in vascular health.
Typical Dosage	800mg (in a 6-week hypertension study) and 2000mg (in a 28-day overweight/obese study).	1000mg (in a 6-week study).
Side Effects	Generally considered safe at recommended doses; potential mild side effects like nausea or diarrhea.	Considered safe with mild, temporary side effects reported in some trials.

Is NAD Right for You if You Have Blood Pressure Concerns?

For individuals with pre-existing cardiovascular conditions, especially hypertension, the decision to supplement with NAD precursors should always be made in consultation with a healthcare professional. While the research is promising regarding the potential blood pressure-lowering benefits of NMN and NR, these are still supplements, not replacements for prescribed medications. Monitoring blood pressure is particularly important if you are on antihypertensive drugs, as there is a risk of potentiating their effects.

The Role of NAD+ in Vascular Function and Oxidative Stress

Beyond direct effects on blood pressure, NAD+ is deeply involved in a complex network of cellular processes that regulate vascular health. The decline of NAD+ with age is closely linked to a rise in chronic, low-grade inflammation, often referred to as "inflammaging". This inflammation damages blood vessels, contributes to arterial stiffening, and impairs endothelial function. By restoring NAD+ levels, supplements can activate key enzymes like sirtuins, which have protective effects on the vasculature by regulating gene expression, reducing inflammation, and enhancing mitochondrial function.

Moreover, NAD+ plays a critical role in managing oxidative stress, another major contributor to vascular aging. By boosting NAD+ levels, precursors can help activate antioxidant pathways, protecting blood vessels from damage and supporting their ability to produce nitric oxide, a vasodilator that helps relax blood vessels and lower blood pressure.

Conclusion

In summary, the notion that NAD raises blood pressure is not supported by current research. Instead, studies indicate that boosting NAD+ levels with precursors like NMN and NR may actually help lower blood pressure and improve other aspects of cardiovascular health, particularly in older adults and those with hypertension. The therapeutic benefits appear to stem from a cascade of effects, including improved endothelial function, reduced arterial stiffness, and diminished inflammation. However, individuals on blood pressure medication or with underlying health conditions should proceed with caution and consult a healthcare provider to ensure safety. The field of NAD+ research is dynamic, and future, larger-scale human trials will continue to clarify its full clinical potential.

This article is for informational purposes only and does not constitute medical advice. Consult a healthcare professional before starting any new supplement regimen.

For more in-depth information on cardiovascular health and research into aging, consult resources like the National Institutes of Health. https://pmc.ncbi.nlm.nih.gov/

Frequently Asked Questions

No, based on current research, NMN (Nicotinamide Mononucleotide) is not known to raise blood pressure. Multiple human trials have indicated that NMN supplementation may actually help lower blood pressure, particularly in older adults and those with hypertension.

NAD+ plays a pivotal role in cardiovascular health by supporting proper vascular function. Its decline with age is linked to vascular problems, while restoring NAD+ levels through supplementation may improve endothelial health, reduce arterial stiffness, and lower inflammation.

It is crucial to consult a healthcare provider before taking NAD+ supplements, especially if you have high blood pressure. While studies suggest a potential benefit, there is a risk that supplementation, particularly at high doses or combined with blood pressure medication, could cause blood pressure to drop too low.

NAD+ supplementation, primarily via precursors like NMN and NR, improves vascular function through several mechanisms. This includes reducing oxidative stress, lowering chronic inflammation, and improving endothelial cell health, which supports healthy blood flow and blood vessel flexibility.

Yes, Nicotinamide Riboside (NR), an NAD+ precursor, has been shown in some studies to have a beneficial effect on blood pressure. For instance, a pilot study found that NR supplementation modestly lowered systolic blood pressure and reduced arterial stiffness in middle-aged and older adults with slightly elevated blood pressure.

While generally well-tolerated, common side effects of NAD+ supplements can include mild issues like nausea, headaches, fatigue, or digestive problems. Intravenous (IV) administration may also cause flushing or injection site reactions. Serious adverse events are rare, but long-term data is limited.

One key mechanism involves NAD+'s effect on CD38, an enzyme that consumes NAD+. Studies show that CD38 levels are elevated in hypertension, leading to lower NAD+ levels. Supplementing with precursors can increase NAD+ and may suppress CD38 activity, helping to lower blood pressure and improve vascular health.