Does pomegranate juice lower blood pressure?

A little, and in short trials. A 2023 meta-analysis of 14 clinical trials of pomegranate juice on its own, in 573 people, found systolic blood pressure fell by 5.02 mm Hg (95% CI 2.48 to 7.55). Going by the wording of its abstract, not every one of those trials was randomized. The same authors found the benefit was lost in trials that ran longer than 2 months. No trial has counted strokes, heart attacks or deaths.

Established. Over a few weeks, pomegranate juice lowers systolic blood pressure by a few mm Hg. Two meta-analyses of juice trials agree on the direction. The 2023 one found 5.02 mm Hg across 14 trials. A 2017 one found 4.96 mm Hg (95% CI 2.25 to 7.67) across 8 randomized placebo-controlled trials, with diastolic pressure down 2.01 mm Hg (95% CI 0.31 to 3.71).

Unsettled. Whether the fall lasts is the open question. The 2023 analysis saw the effect in trials of 2 months or less and lost it after that. The 2017 analysis still found 4.36 mm Hg in trials longer than 12 weeks, with an interval that runs down to 0.82. From the abstracts we could not see how many long trials each review pooled, so the disagreement stays open.

What the trials found

Duration

In the 2023 juice-only analysis, trials of 2 months or less showed systolic pressure 4.59 mm Hg lower (95% CI 2.08 to 7.10) and diastolic 2.94 mm Hg lower (95% CI 0.63 to 5.25). The authors write that the benefit was lost after 2 months of drinking the juice. The 2017 analysis of 8 randomized trials found 5.83 mm Hg (95% CI 1.61 to 10.05) in trials shorter than 12 weeks and 4.36 mm Hg in longer ones. The two reviews disagree on duration, and their abstracts do not say how many long trials each one pooled.

Dose

More juice did not clearly do more. In the 2023 analysis, up to 10 fl oz (300 mL) a day lowered systolic pressure by 6.11 mm Hg (95% CI 3.00 to 9.22). Above 10 fl oz (300 mL) a day the fall was 3.28 mm Hg and its interval crossed zero. The 2017 analysis split at 8.1 fl oz (240 mL) a day and found the larger fall in the smaller-dose trials: 11.01 mm Hg (95% CI 4.65 to 17.38) below 8.1 fl oz (240 mL) against 3.62 mm Hg (95% CI 0.63 to 6.62) above it.

Starting blood pressure

A 2024 meta-analysis of 22 randomized trials of pomegranate in any form, juice and extracts together, found a larger fall in systolic pressure in people starting above 130 mm Hg than in people starting below it. The abstract does not give the size of that difference. Overall it found 7.87 mm Hg (95% CI 5.39 to 10.34), with the trials disagreeing strongly with each other (I2 about 90%).

The critical review

A 2017 systematic review of 8 randomized trials in 619 people did not pool the numbers. It counted results trial by trial instead. Two trials showed a significant fall in systolic pressure, three found no difference between groups, and three never reported the between-group comparison. Its conclusion was that the limited evidence fails to convincingly show a benefit of pomegranate on blood pressure.

Single trials

In 51 healthy adults aged 30 to 50, 11 fl oz (330 mL) a day for 4 weeks against a placebo drink lowered systolic pressure by 3.14 mm Hg and diastolic by 2.33 mm Hg. In 21 adults with high blood pressure, 5.1 fl oz (150 mL) of fresh juice a day for 2 weeks lowered both readings compared with water (p = 0.002 and p = 0.038), and the abstract gives no size in mm Hg. In 60 people with type 2 diabetes, 6.8 fl oz (200 mL) a day for 6 weeks left both readings lower than in a group that got no drink at all. In women with polycystic ovary syndrome, 10 fl oz (300 mL) a day for 8 weeks left blood pressure lower than a placebo drink, with neither the number of women nor the size of the change in the abstract. In 24 people on hemodialysis, 3.4 fl oz (100 mL) before each session for 4 weeks did not change pre-dialysis blood pressure.

The proposed mechanism

An early uncontrolled study in people with high blood pressure reported a 36% fall in the activity of ACE, the enzyme that blood pressure drugs called ACE inhibitors block, and a 5% fall in systolic pressure. It had no control group and its abstract gives neither the number of people nor the change in mm Hg. The 4-week trial in 51 healthy adults found no change in ACE at all, so the mechanism is still a proposal.

Who should be careful

The trials themselves were quiet on harm. The 2017 review of 8 trials in 619 people found no adverse events, though trials this small and short are not built to find rare ones. The US National Center for Complementary and Integrative Health says pomegranate usually has no side effects, that some people get digestive symptoms, and that allergic reactions have been reported.

A 248 g glass of 100% pomegranate juice carries 31.4 g of sugars, 133.9 calories and 530.7 mg of potassium, by the US food composition tables. Commercial juices vary. That sugar matters if you have diabetes or are watching weight, and the trial doses of 6.8 to 11 fl oz (200 to 330 mL) a day sit around one glass. The potassium matters in kidney failure. The dialysis trial used 3.4 fl oz (100 mL) servings and found the juice well tolerated in 24 people over 4 weeks, which is too small and too short to show that juice fits a potassium-restricted diet.

Not for everyone. If you take blood pressure medicine, we found no trial of pomegranate juice on top of an ACE inhibitor or any other blood pressure drug, and the juice is not a replacement for one. For other drugs the controlled data are reassuring and thin. Juice and extract did not change how the body handled a CYP2C9 probe drug in human volunteers, and in 12 healthy people the changes to midazolam and dapoxetine were slight and not significant. Two single case reports sit against that. A woman on warfarin saw her INR drop below range after she stopped drinking the juice, and a man on rosuvastatin with a possible underlying muscle disease reached a creatine kinase of 138,030 U/L three weeks after starting the juice. Causality is uncertain in both. If you take warfarin, keep juice intake steady and tell the person treating you.

What expert bodies say

The US National Center for Complementary and Integrative Health says pomegranate juice or extract may be helpful in reducing blood pressure and that more research is needed to confirm it. The EU register lists the claim that pomegranate juice supports the cardiovascular system as non-authorized. That means the evidence did not meet the bar when it was assessed, which is a different thing from proof of no effect.

How we searched

What would change this answer

• A randomized trial longer than 2 months, juice against a matched placebo drink, with blood pressure as the main outcome. That would settle the disagreement between the two meta-analyses about whether the effect fades.
• A trial in people already taking blood pressure medicine. We found none.
• Any trial that counts strokes, heart attacks or deaths. Blood pressure is a marker, and a few mm Hg over a few weeks is not yet a health outcome.
• The full texts of the meta-analyses, which would show how many of the pooled trials were randomized and how large the difference by starting blood pressure really is.

More on the drink itself: pomegranate juice, and the wider question of pomegranate juice and heart health.

Sources

1. ev-pjbp-01 · Meta-analysis or systematic review · systematic review and random-effects meta-analysis of clinical trials of pomegranate juice alone · n = 14 trials, 573 individuals
   Meta-analysis of 14 clinical trials (n = 573 individuals) demonstrated a reduction in systolic BP (SBP) with pomegranate juice (MD: -5.02 mmHg, 95% CI: -7.55 to -2.48, p < 0.001).
   
   Who: participants in clinical trials of pomegranate juice alone, human studies in English
   Effect: SBP MD -5.02 mm Hg (95% CI -7.55 to -2.48)
   Certainty: Best and newest juice-only synthesis; included trials not all randomized per abstract wording; full text not in PMC; outside corpus snapshot.
   Phytotherapy Research, 2023 (impact of pomegranate juice on blood pressure: systematic review and meta-analysis) · checked 2026-10-07 · we read the abstract
2. ev-pjbp-02 · Meta-analysis or systematic review · subgroup analysis by duration within a meta-analysis · n = 14 trials, 573 individuals
   Pomegranate juice appeared to decrease SBP and DBP in a dose-dependent manner, but the benefit was lost after 2 months of pomegranate juice intake.
   
   Who: participants in clinical trials of pomegranate juice alone
   Effect: duration <=2 months: SBP MD -4.59 mm Hg (95% CI -7.10 to -2.08), DBP MD -2.94 mm Hg (95% CI -5.25 to -0.63); benefit lost after 2 months
   Certainty: Subgroup finding; few long trials; the open question is whether any effect lasts.
   Phytotherapy Research, 2023 (impact of pomegranate juice on blood pressure: systematic review and meta-analysis) · checked 2026-10-07 · we read the abstract
3. ev-pjbp-03 · Meta-analysis or systematic review · subgroup analysis by daily dose within a meta-analysis · n = 14 trials, 573 individuals
   Consumption of ≤300 mL pomegranate juice daily reduced SBP (MD: -6.11 mmHg, 95% CI: -9.22 to -3.00, p < 0.001).
   
   Who: participants in clinical trials of pomegranate juice alone
   Effect: <=300 mL/day: SBP MD -6.11 mm Hg (95% CI -9.22 to -3.00); >300 mL/day: SBP MD -3.28 mm Hg (95% CI -6.85 to 0.27), DBP MD -3.10 mm Hg (95% CI -5.74 to -0.47)
   Certainty: Dose subgroup; authors call the >10 fl oz (300 mL) result counterintuitive; meta-regression still links effect to dose. More juice is not shown to help more.
   Phytotherapy Research, 2023 (impact of pomegranate juice on blood pressure: systematic review and meta-analysis) · checked 2026-10-07 · we read the abstract
4. ev-pjbp-04 · Meta-analysis or systematic review · subgroup analysis within a random-effects meta-analysis of randomized placebo-controlled trials · n = 8 RCTs
   Pomegranate juice reduced SBP regardless of the duration (>12 wks: WMD=-4.36mmHg, 95% CI: -7.89 to -0.82, p=0.016) and <12 wks: WMD=-5.83 mmHg, 95% CI: -10.05 to -1.61, p=0.007) and dose consumed (>240cc: WMD=-3.62mmHg, 95% CI: -6.62 to -0.63, p=0.018) and <240cc: WMD=-11.01mmHg, 95% CI: -17.38 to -4.65, p=0.001, pomegranate juice per day) whereas doses >240cc provided a borderline significant effect in reducing DBP.
   
   Who: adults in randomized placebo-controlled trials of pomegranate juice
   Effect: >12 weeks: SBP WMD -4.36 mm Hg (95% CI -7.89 to -0.82); <12 weeks: SBP WMD -5.83 mm Hg (95% CI -10.05 to -1.61); <240 mL/day: SBP WMD -11.01 mm Hg (95% CI -17.38 to -4.65)
   Certainty: Overall pooled numbers carded in the heart-health pair; this card holds the subgroups, which partly disagree with 37461211 on duration.
   Pharmacol Res, 2017 · checked 2026-10-07 · we read the abstract
5. ev-pjbp-05 · Meta-analysis or systematic review · subgroup analysis within a systematic review and meta-analysis of RCTs · n = 22 RCTs
   Individuals with baseline SBP > 130 mmHg had a significantly greater reduction in SBP compared to individuals with baseline SBP < 130 mmHg.
   
   Who: adults consuming pomegranate in different forms in randomized clinical trials, searched to January 2024
   Effect: greater SBP reduction with baseline SBP > 130 mm Hg vs < 130 mm Hg; size of the difference not given in abstract
   Certainty: Size of the subgroup difference not given in the abstract; very high heterogeneity; mixes juice and extracts. Overall result carded in the heart-health pair.
   Phytotherapy Research, 2024 (pomegranate consumption and blood pressure in adults: systematic review and meta-analysis) · checked 2026-10-07 · we read the abstract
6. ev-pjbp-06 · Meta-analysis or systematic review · systematic review of randomized clinical trials with Cochrane reporting-quality appraisal, no pooling · n = 619 (8 RCTs)
   Two studies reported significant reductions in systolic blood pressure favoring pomegranate: p = .002 and p < .001 respectively; 3 studies reported no significant differences between groups; and 3 studies failed to report between-group differences.
   
   Who: adults in randomized clinical trials of pomegranate juice or capsules vs control
   Effect: SBP: 2 of 8 trials significant reduction, 3 no between-group difference, 3 between-group results not reported
   Certainty: Counterweight to the pooled meta-analyses: poor reporting in half the trials. Conclusion sentence carded in the heart-health pair.
   Nutr Res, 2017 · checked 2026-10-07 · we read the abstract
7. ev-pjbp-07 · Meta-analysis or systematic review · systematic review of randomized clinical trials · n = 619 (8 RCTs)
   No adverse events were observed.
   
   Who: adults in randomized clinical trials of pomegranate juice or capsules vs control
   Effect: no adverse events observed
   Certainty: Short small trials are not built to find rare harms; drug interactions, sugar and potassium in the heart-health pair.
   Nutr Res, 2017 · checked 2026-10-07 · we read the abstract
8. ev-pjbp-08 · Randomized controlled trial(s) · randomized placebo-controlled parallel trial, 330 mL/day for 4 weeks · n = 51
   However, there was a significant fall in systolic blood pressure (-3.14 mmHg, P < 0.001), diastolic blood pressure (-2.33 mmHg P < 0.001) and mean arterial pressure (-2.60 mmHg, P < 0.001).
   
   Who: healthy adults aged 30 to 50 years
   Effect: SBP -3.14 mm Hg, DBP -2.33 mm Hg, MAP -2.60 mm Hg (all P < 0.001); serum ACE unchanged
   Certainty: Short, small, normotensive; no ACE change argues against the ACE mechanism in 11500191.
   Plant Foods Hum Nutr, 2012 · checked 2026-10-07 · we read the abstract
9. ev-pjbp-09 · Randomized controlled trial(s) · randomized controlled trial, 150 mL/day fresh juice vs water for 2 weeks · n = 21 (11 juice, 10 water)
   PJ consumption was associated with significant reductions in SBP (p = 0.002) and DBP (p = 0.038) but not FMD (p > 0.05).
   
   Who: hypertensive patients aged 30 to 67 years
   Effect: significant reductions in SBP (p = 0.002) and DBP (p = 0.038); FMD unchanged; mm Hg size not given in abstract
   Certainty: Very small, very short; the abstract gives p-values but no size; full text not in PMC.
   Phytotherapy Research, 2014 (blood pressure and endothelial effects of pomegranate juice in hypertensive subjects) · checked 2026-10-07 · we read the abstract
10. ev-pjbp-10 · Randomized controlled trial(s) · single-blind randomized clinical trial, 200 mL/day for 6 weeks vs no intervention · n = 60 (30 per group)
    Similarly, SBP and DBP in the intervention group were significantly lower than the control group after intervention (P < 0.02 and P < 0.03, respectively).
    
    Who: patients with type 2 diabetes, Iran
    Effect: SBP and DBP lower than control after 6 weeks (P < 0.02 and P < 0.03); size of between-group difference not given
    Certainty: Control got nothing; abstract reports pressure in cm Hg-like units, size unclear. Lipid conclusion carded in the heart-health pair.
    Clin Nutr ESPEN, 2019 · checked 2026-10-07 · we read the abstract
11. ev-pjbp-11 · Randomized controlled trial(s) · randomized triple-blind placebo-controlled 4-arm trial, 300 mL/day for 8 weeks · n = —
    Blood pressure (BP) was lower in the SPJ and PJ groups compared to placebo (P < 0.001; P < 0.01, respectively).
    
    Who: women with polycystic ovary syndrome, Iran
    Effect: BP lower than placebo in pomegranate juice (P < 0.01) and synbiotic pomegranate juice (P < 0.001) groups; size not given in abstract
    Certainty: Number randomized and mm Hg not in abstract; full text not checked (no PMC).
    J Endocrinol Invest, 2020 · checked 2026-10-07 · we read the abstract
12. ev-pjbp-12 · Randomized controlled trial(s) · randomized crossover pilot trial, juice vs extract, 4-week periods · n = 24
    Both pomegranate juice and extract were safe and well tolerated by study participants.
    
    Who: patients on maintenance hemodialysis, 64% men, mean age 61 years
    Effect: no significant effect on predialysis systolic or diastolic BP; safe and well tolerated
    Certainty: Pilot, crossover between two pomegranate forms, no placebo arm. Juice potassium matters in kidney failure; small servings were used.
    J Ren Nutr, 2015 · checked 2026-10-07 · we read the abstract
13. ev-pjbp-13 · Observational data · uncontrolled before-after study, 50 mL/day (1.5 mmol total polyphenols) for 2 weeks · n = —
    A 36% decrement in serum ACE activity and a 5% reduction in systolic blood pressure were noted.
    
    Who: hypertensive patients
    Effect: serum ACE activity -36%; SBP -5%
    Certainty: No control group, n not in abstract; the ACE-blocking idea is the usual proposed mechanism but 22648092 saw no ACE change. Overlap with ACE-inhibitor drugs is untested.
    Atherosclerosis, 2001 (pomegranate juice, serum ACE activity and systolic blood pressure) · checked 2026-10-07 · we read the abstract
14. ev-pjbp-14 · Position of an expert body · agency fact sheet · n = —
    Pomegranate juice or extract may be helpful in reducing blood pressure, but additional research is needed to confirm this effect.
    
    Who: general public
    Effect: possible benefit, unconfirmed
    Certainty: Agency position, no own analysis; consistent with the meta-analyses being modest and heterogeneous.
    NIH NCCIH, Pomegranate (fact sheet, last updated April 2025) · checked 2026-10-07 · we read the section
15. ev-pjbp-15 · Position of an expert body · agency fact sheet · n = —
    Pomegranate usually doesn’t have side effects, but some people may have digestive tract symptoms. Allergic reactions to pomegranate have been reported.
    
    Who: general public
    Effect: digestive symptoms in some; allergic reactions reported
    Certainty: Agency safety summary; the same page says juice is believed safe and advises talking to a clinician if taking any medicine.
    NIH NCCIH, Pomegranate (fact sheet, last updated April 2025) · checked 2026-10-07 · we read the section
16. ev-pomjhh-01 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized placebo-controlled trials · n = 8 RCTs
    Quantitative data synthesis from 8 RCTs showed significant reductions in both systolic [weighed mean difference (WMD): -4.96mmHg, 95% CI: -7.67 to -2.25, p<0.001) and diastolic BP (WMD: -2.01mmHg, 95% CI: -3.71 to -0.31, p=0.021) after pomegranate juice consumption.
    
    Who: adults in randomized placebo-controlled trials of pomegranate juice
    Effect: SBP WMD -4.96 mm Hg (95% CI -7.67 to -2.25); DBP WMD -2.01 mm Hg (95% CI -3.71 to -0.31)
    Certainty: Best juice-specific synthesis; small trials, short; blood pressure is a marker, not a heart event.
    Pharmacol Res, 2017 · checked 2026-10-07 · we read the abstract
17. ev-pomjhh-02 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized controlled trials · n = 22 RCTs
    Our meta-analysis of the pooled findings showed that pomegranate consumption significantly reduced SBP (WMD: -7.87 mmHg; 95% CI: -10.34 to -5.39; p < 0.001) and DBP (WMD: -3.23 mmHg; 95% CI: -5.37 to -1.09; p = 0.003).
    
    Who: adults consuming pomegranate in different forms in randomized clinical trials
    Effect: SBP WMD -7.87 mm Hg (95% CI -10.34 to -5.39); DBP WMD -3.23 mm Hg (95% CI -5.37 to -1.09); heterogeneity I2 90.0% (SBP), 91.8% (DBP)
    Certainty: Mixes juice, extract and other forms; very high heterogeneity; authors ask for higher-quality trials. PMID outside the local corpus.
    Phytotherapy Research, 2024 (pomegranate consumption and blood pressure in adults: systematic review and meta-analysis) · checked 2026-10-07 · we read the abstract
18. ev-pomjhh-06 · Meta-analysis or systematic review · systematic review of randomized clinical trials with Cochrane risk-of-bias appraisal, no pooling · n = 619 (8 RCTs)
    The limited evidence from clinical trials to date fails to convincingly show a beneficial effect of pomegranate on blood pressure.
    
    Who: adults in randomized clinical trials of pomegranate juice or capsules vs control
    Effect: 2 of 8 trials showed significant SBP fall, 3 no difference, 3 did not report between-group results; no adverse events
    Certainty: Counterweight to the pooled MAs: same trial base read critically.
    Nutr Res, 2017 · checked 2026-10-07 · we read the abstract
19. ev-pomjhh-11 · Randomized controlled trial(s) · randomized controlled crossover pharmacokinetic study · n = —
    Despite inhibition of CYP2C9 in vitro, pomegranate juice and extract had no effect on CYP2C9 activity in human subjects, and can be consumed by patients taking CYP2C9 substrate drugs with negligible risk of a pharmacokinetic interaction.
    
    Who: human volunteers, pomegranate juice or 1 g extract vs low-polyphenol placebo drink, fluconazole as positive control
    Effect: flurbiprofen pharmacokinetics unchanged; fluconazole reduced clearance
    Certainty: Probe substrate, not warfarin itself; n not stated in abstract.
    Clin Pharmacol Ther, 2012 · checked 2026-10-07 · we read the abstract
20. ev-pomjhh-12 · Randomized controlled trial(s) · open-label three-way crossover · n = 12
    Slight but not statistically significant changes were observed in the pharmacokinetics of dapoxetine and midazolam after pretreatment with PJ.
    
    Who: 12 healthy subjects, 8.5 fl oz (250 mL) water, grapefruit or pomegranate juice for 3 days before dapoxetine 60 mg and midazolam 7.5 mg
    Effect: pomegranate juice: slight, non-significant changes; grapefruit juice: midazolam AUC +75%, dapoxetine AUC +60%
    Certainty: Small, healthy subjects; relevant to CYP3A4-cleared heart drugs such as some statins.
    Eur J Drug Metab Pharmacokinet, 2017 · checked 2026-10-07 · we read the abstract
21. ev-pomjhh-13 · Laboratory or animal data · case report · n = 1
    During that time, the patient was consuming pomegranate juice 2-3 times/week. She stopped drinking the juice, and her INRs became subtherapeutic.
    
    Who: one 64-year-old woman on warfarin 4 mg/day for recurrent deep vein thrombosis
    Effect: INR became subtherapeutic after stopping juice; warfarin dose raised; possible relationship by Drug Interaction Probability Scale
    Certainty: Single case, no rechallenge; controlled PK data (ev-pomjhh-11) show no CYP2C9 effect. People on warfarin should keep juice intake steady and tell their clinician.
    Pharmacotherapy, 2009 · checked 2026-10-07 · we read the abstract
22. ev-pomjhh-14 · Laboratory or animal data · case report · n = 1
    Three weeks before presentation, he began drinking pomegranate juice (200 ml twice weekly). He presented urgently with thigh pain and an elevated serum creatine kinase level (138,030 U/L, normal < 200 U/L).
    
    Who: one 48-year-old man with possible underlying myopathy on rosuvastatin 5 mg every other day and ezetimibe 10 mg/day
    Effect: creatine kinase 138,030 U/L (normal under 200)
    Certainty: Single case with possible pre-existing myopathy; causality uncertain.
    Am J Cardiol, 2006 · checked 2026-10-07 · we read the abstract
23. ev-pomjhh-15 · Position of an expert body · regulatory decision · n = —
    POL-HC-7795 Pomegranate juice Pomegranate juice: plays an important antioxidative function; supports the cardiovascular system. Non-authorised
    
    Who: EU food labeling
    Effect: claim non-authorized
    Certainty: Non-authorized means the evidence did not meet the EFSA bar at assessment, not proof of no effect.
    EU Register on nutrition and health claims, claim POL-HC-7795, snapshot 2026-09-21 · checked 2026-10-07 · we read the section
24. ev-pomjhh-16 · Position of an expert body · reference dataset, not a study · n = 1 food code
    FNDDS 2709330 Pomegranate juice, 100% (64126000): Energy 54 kcal/100 g, Quantity not specified 248 g 133.9 kcal · Total Sugars 12.65 g/100 g, 248 g 31.4 g · Potassium, K 214 mg/100 g, 248 g 530.7 mg · Vitamin C, total ascorbic acid 0.1 mg/100 g, 248 g 0.2 mg · 1 fl oz (no ice) 31 g
    
    Who: US household measures, FNDDS
    Effect: per 248 g: 133.9 calories, total sugars 31.4 g, potassium 530.7 mg
    Certainty: Trial doses of 6.8 to 11 fl oz (200 to 330 mL) a day add this sugar load; relevant for diabetes and weight. Commercial juices vary.
    USDA FNDDS 2021-2023 · checked 2026-10-07 · we read the dataset