Is pomegranate juice good for heart health?

It lowers blood pressure a little, and that is close to all the evidence shows. A 2017 meta-analysis of 8 randomized placebo-controlled trials of the juice found systolic pressure fell by 4.96 mm Hg (95% CI 2.25 to 7.67) and diastolic by 2.01 mm Hg. The trials were small and short, and blood pressure is a marker rather than a heart attack. No trial has counted heart attacks, strokes or deaths, and the longest one, 18 months in 289 adults at moderate risk, found no slowing of artery thickening.

Established. Pomegranate juice lowers blood pressure by a few mm Hg in short trials. Two meta-analyses agree on the direction: 4.96 mm Hg systolic across 8 juice trials, and 7.87 mm Hg (95% CI 5.39 to 10.34) across 22 trials of pomegranate in any form.

Unsettled. How large the fall really is remains unclear. The 22 trials in the 2024 analysis disagreed with each other so much (I2 90% for systolic pressure) that one pooled number hides a wide spread, and they mixed juice with extracts. A 2017 systematic review of 8 trials in 619 people read the same evidence and judged it too weak to show a convincing benefit.

What the trials found

Blood pressure

The widest synthesis, a 2025 dose-response meta-analysis of 53 trials with 2306 participants, found pomegranate lowered systolic and diastolic pressure with standardized differences of 0.49 and 0.39. Those are small to moderate effects on a statistical scale, they cover every form of pomegranate, and the full text was not available to us. In the 2017 systematic review that judged the evidence weak, only 2 of 8 trials showed a significant fall in systolic pressure, 3 showed no difference and 3 did not report a comparison between groups.

The single trials point the same way at a similar size. In 51 healthy adults aged 30 to 50, 11 fl oz (330 mL) of juice a day for 4 weeks lowered systolic pressure by 3.14 mm Hg and diastolic by 2.33 mm Hg. In 60 people with type 2 diabetes in Iran, 6.8 fl oz (200 mL) a day for 6 weeks lowered both against a control group that got no juice, in a single-blind design.

Cholesterol

Myth. Pomegranate juice is not a cholesterol treatment. The 53-trial analysis found no substantial change in LDL cholesterol or triglycerides. A 2016 meta-analysis of 12 trials in 545 people found no significant effect on any blood lipid, and in the diabetes trial lipids did not differ between groups.

The 53-trial analysis did find a small fall in total cholesterol, a standardized difference of 0.12 with an interval whose upper end reaches zero, and a small rise in HDL of 0.27. With LDL unchanged, that is not a pattern that says much about the arteries.

The arteries themselves

The longest and largest juice trial gave 8.1 fl oz (240 mL) a day for 18 months to men aged 45 to 74 and women aged 55 to 74 with at least one major coronary risk factor, 146 on juice and 143 on control. There was no significant difference in how fast the carotid artery wall thickened. In the 4-week trial in healthy adults, arterial stiffness measured as pulse wave velocity did not change.

In 24 people on maintenance hemodialysis, 3.4 fl oz (100 mL) of juice before each session for 4 weeks was safe and well tolerated, and did not change blood pressure, lipids or markers of inflammation.

Who should be careful

People taking warfarin. Controlled studies in human volunteers found pomegranate juice and extract did not change the activity of CYP2C9, the enzyme that clears warfarin. A single case report still describes a 64-year-old woman on steady warfarin who drank the juice 2 to 3 times a week, and whose INR fell below target after she stopped. One case without a rechallenge cannot show cause. Keeping the habit steady and telling the clinician who doses the warfarin is the sensible response to both findings.

People on statins. A single case report describes a 48-year-old man, possibly with an underlying muscle disorder, on rosuvastatin and ezetimibe, who developed severe muscle breakdown with creatine kinase at 138,030 U/L three weeks after starting 6.8 fl oz (200 mL) of juice twice a week. Whether the juice caused it is uncertain. In a crossover trial of 12 healthy adults, three days of 8.5 fl oz (250 mL) a day caused only slight, non-significant changes in midazolam, a probe for CYP3A4, the enzyme that clears several statins, while grapefruit juice raised it by 75%.

People watching sugar or potassium. A 248 g glass of 100% pomegranate juice carries about 134 calories, 31 g of sugars and 531 mg of potassium, by the USDA figures, and commercial juices vary. The trial doses of 6.8 to 11 fl oz (200 to 330 mL) a day add that load every day. In the dialysis trial the servings were kept to 3.4 fl oz (100 mL).

Not for everyone. If you take warfarin, a statin or another heart drug, or you have diabetes or kidney disease, a daily glass is worth mentioning to whoever manages your treatment.

We have no card on pregnancy or children for this question.

What expert bodies say

The EU did not authorize the health claim that pomegranate juice supports the cardiovascular system. That means the evidence did not meet the bar when it was assessed, which is different from proof that there is no effect. We found no position from the American Heart Association, NICE, the NIH Office of Dietary Supplements or EFSA on pomegranate juice and heart health, and no Cochrane review.

How we searched

What would change this answer

• A randomized trial that counts heart attacks, strokes or deaths. None exists, and ClinicalTrials.gov lists no ongoing cardiovascular outcome trial of pomegranate.
• A larger and longer trial of the juice alone, with blood pressure as its main endpoint and results that agree with each other, would settle how big the blood pressure effect is.

For what pomegranate juice contains and how it fits a diet, see the pomegranate juice page.

Sources

1. 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
2. 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
3. ev-pomjhh-03 · Meta-analysis or systematic review · systematic review and dose-response meta-analysis of randomized controlled trials · n = 53 RCTs, 2306 participants
   The findings revealed that PO supplementation substantially reduced body weight (standardized mean difference (SMD): -0.14 kg, 95 % CI: -0.25, -0.03; P = 0.01), diastolic blood pressure (DBP) (SMD: -0.39 mmHg, 95 % CI: -0.59, -0.18; P < 0.001), body mass index (BMI) (SMD: -0.17 kg/m2, 95 % CI: -0.30, -0.04; P = 0.01), systolic blood pressure (SBP) (SMD: -0.49 mmHg, 95 % CI: -0.68, -0.31; P < 0.001), serum fasting blood glucose (FBG) (SMD: -0.15 mg/dL, 95 % CI: -0.26, -0.04; P = 0.01), and total cholesterol (TC) (SMD: -0.12 mg/dL, 95 % CI: -0.24, -0.00; P = 0.04) while elevating high-density lipoprotein (HDL) levels (SMD: 0.27 mg/dL, 95 % CI: 0.08, 0.47; P < 0.001) compared to control groups.
   
   Who: participants in randomized controlled trials of pomegranate supplementation published until January 2024
   Effect: SBP SMD -0.49 (95% CI -0.68 to -0.31); DBP SMD -0.39 (95% CI -0.59 to -0.18); TC SMD -0.12 (95% CI -0.24 to -0.00); HDL SMD 0.27 (95% CI 0.08 to 0.47)
   Certainty: Widest synthesis; all pomegranate forms, not juice only; effects in standardized units, small; full text not in PMC.
   Nutr Metab Cardiovasc Dis, 2025 · checked 2026-10-07 · we read the abstract
4. ev-pomjhh-04 · Meta-analysis or systematic review · systematic review and dose-response meta-analysis of randomized controlled trials · n = 53 RCTs, 2306 participants
   No substantial changes were observed in waist-to-hip ratio (WHR), homeostatic model assessment of insulin resistance (HOMA-IR), waist circumference (WC), serum values of hemoglobin A1c (HbA1c), alanine transaminase (ALT), triglycerides (TG), low-density lipoprotein (LDL), insulin, and aspartate transferase (AST) levels between PO and placebo groups.
   
   Who: participants in randomized controlled trials of pomegranate supplementation
   Effect: no substantial change in LDL, triglycerides, HbA1c, insulin, HOMA-IR, waist measures or liver enzymes vs placebo
   Certainty: Null on the main atherogenic lipid.
   Nutr Metab Cardiovasc Dis, 2025 · checked 2026-10-07 · we read the abstract
5. ev-pomjhh-05 · Meta-analysis or systematic review · systematic review and fixed-effect meta-analysis of randomized placebo-controlled trials · n = 545 (12 RCTs, 13 arms)
   Fixed-effect meta-analysis of data from 12 RCTs (13 treatment arms) did not show any significant effect of pomegranate consumption on plasma lipid concentrations.
   
   Who: individuals in randomized placebo-controlled trials of pomegranate and plasma lipids
   Effect: no significant effect on total cholesterol, LDL-C, HDL-C or triglycerides
   Certainty: Older and smaller than 40617711, consistent on LDL and TG.
   Phytomedicine, 2016 · checked 2026-10-07 · we read the abstract
6. 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
7. ev-pomjhh-07 · Randomized controlled trial(s) · randomized double-blind parallel multicentre trial, 240 mL/day for up to 18 months · n = 289 (146 juice, 143 control)
   No significant difference in overall CIMT progression rate was observed between pomegranate juice and control treatments.
   
   Who: men 45 to 74 and women 55 to 74 years with at least one major coronary risk factor and posterior wall CIMT 0.7 to 2.0 mm
   Effect: no significant difference in overall CIMT progression rate
   Certainty: Longest and largest juice trial on an artery-structure endpoint; subgroup signals are exploratory.
   Am J Cardiol, 2009 · checked 2026-10-07 · we read the abstract
8. ev-pomjhh-08 · Randomized controlled trial(s) · randomized placebo-controlled parallel trial, 330 mL/day for 4 weeks · n = 51
   We conclude that pomegranate juice supplementation has benefits for BP in the short term, but has no effect on PWV.
   
   Who: healthy adults aged 30 to 50 years
   Effect: PWV unchanged (P = 0.694); SBP -3.14 mm Hg, DBP -2.33 mm Hg, MAP -2.60 mm Hg (all P < 0.001)
   Certainty: Short, small, healthy volunteers.
   Plant Foods Hum Nutr, 2012 · checked 2026-10-07 · we read the abstract
9. ev-pomjhh-09 · Randomized controlled trial(s) · single-blind randomized clinical trial, 200 mL/day for 6 weeks vs no intervention · n = 60 (30 per group)
   It is concluded that PJ consumption could decrease systolic and diastolic blood pressure in patients with diabetes while having no effect on lipid profile.
   
   Who: patients with type 2 diabetes, Iran
   Effect: SBP and DBP lower than control after 6 weeks (P < 0.02, P < 0.03); TC, TG, LDL-C, HDL-C no between-group difference
   Certainty: Control group got nothing, single-blind; short.
   Clin Nutr ESPEN, 2019 · checked 2026-10-07 · we read the abstract
10. ev-pomjhh-10 · Randomized controlled trial(s) · randomized crossover pilot trial, juice vs extract, 4-week periods · n = 24
    Both pomegranate juice and extract are safe and well tolerated by patients undergoing MHD but do not influence markers of inflammation or oxidative stress nor affect predialysis blood pressure.
    
    Who: patients on maintenance hemodialysis, 64% men, mean age 61 years
    Effect: safe and well tolerated; no change in lipids, CRP, IL-6, F2-isoprostanes or predialysis SBP/DBP
    Certainty: Pilot; potassium in juice matters for dialysis patients and was handled by small 3.4 fl oz (100 mL) servings.
    J Ren Nutr, 2015 · checked 2026-10-07 · we read the abstract
11. 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
12. 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
13. 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
14. 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
15. 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
16. 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