Blood Pressure, Nitric Oxide, and Nutrition



As I mentioned in a recent post, I’ve been trying some nutritional steps to naturally lower blood pressure, with some success. But overall I’d say I’m disappointed. As I mentioned, I tried the suggestions in the book Thirty Days to Natural Blood Pressure Control: The “No Pressure” Solution . To be fair, I haven’t given it 30 days yet. maybe I need to be more patient. But at my last visit my Doctor mentioned the role of nutrition on having adequate nitric oxide levels. This is helpful for blood pressure I’ll discuss below.. This led me to read the book Functional Nitric Oxide Nutrition: Dietary Strategies to Prevent and Treat Chronic Disease, by Dr. Nathan Bryan, a pioneering author in the field.

What a fascinating scientific rabbit hole that led me down! Nitric oxide (NO) is an important chemical in various processes in the body. It’s importance was only recently discovered, which led to a Nobel prize in medicine. For the purposes of blood pressure, it’s vital role is in signaling the arteries to dilate. Nitric oxide levels tend to decline with age, which is a major contributor to increasing hypertension with age. But there are fascinating nuances.

The body makes it’s own (endogenous) nitric oxide inside the arterial walls, which is plenty enough to do the job until we get to around our 40s. After that, accumulating damage to the arterial wall (endothelium) makes this not work too well. You can find a lot of research on exercise leading to arterial dilation (just google “exercise and vasodilation”). But do the search for older adults and you get a more disappointing story. For example, ref [1] found exercise did not improve either aortic stiffness or systolic blood pressure in older adults (55-75 years old),

Blood Pressure, Nitric Oxide, and Nutrition 1
Changes in Arterial Wall with Aging That Reduce Ability to Produce Nitric Oxide

Dr Bryan explains that, but then gives the good news that there is another path (the “exogenous” path) to making nitric oxide, through nutrition. We can get nitrates in foods from many healthy food sources. The body can convert nitrate to nitrite and finally to nitric oxide. Some of the foods include arugula, beets, pomegranate, walnuts, garlic, Italian herbs, and ginger. You’ll see these listed in lots of places if you search for foods that lower blood pressure. But the devil is in the details here. There’s a couple of ways this won’t work.

The body can’t do the nitrate to nitrite step without the help of beneficial bacteria. You’ve probably heard about the importance of beneficial bacterial in our guts. But the ones needed for nitrate processing are on our tongues! They do their work through the saliva. So if we do things like use antibacterial mouthwashes and kill these good mouth germs, the process won’t work. Also the stomach juices need to be acidic enough for this to work, so chronic use of antacids doesn’t help.

Blood Pressure, Nitric Oxide, and Nutrition 2

I put this all to the test, and started eating foods that contain a lot of nitrates, from the list above. It turns out it’s easy to use pom. juice, arugula, and ginger in smoothies for example. It’s been a few days but so far still no big effect.

Back to Drugs, At Least For Now

I am overdo for a visit to my cardiologist anyway, but it usually takes a month or so to get into see him.. I know the first thing he’ll do if my blood pressure reads high in his office is put me back on metoprolol. And probably gives me a stern lecture for going off it (He’s actually a nice guy, but justifiably, he won’t be pleased). So I requested a refill for it and will start taking it before I see him. I’ll continue with the diet changes, they are healthy in their own right. Hopefully they’ll have an effect over time and I can reduce my drug dosage or even get off it. Under medical supervision this time!

I am glad of the learning opportunity of this little blood pressure adventure, though. It’s interesting that the ability to produce enough nitric oxide declines with age even in the very active. It might be preventable if you are active and have a good diet from a younger age. In my case, I ate a pretty average, not particularly healthy diet at least until my 50s, Now I’m interested in reading up on what measures can be take to reverse endothelial damage.


  1. Stewart, K, et al, Effect of exercise on blood pressure in older persons: a randomized controlled trial, Arch Intern Med,. 2005 (link)