Life Extension Magazine®

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How Pomegranate Promotes Heart Health

Nutrient-dense pomegranate protects the heart and endothelium. In a clinical study pomegranate substantially reduced arterial plaque.

Scientifically reviewed by: Dr. Gary Gonzalez, MD, in February 2023. Written by: Richard Stevens.

Pomegranate is a nutrient-dense food with compounds that promote heart health.1-4

Preclinical and clinical studies show that pomegranate can improve blood flow,6,7 reduce arterial blood clots,5 and modestly lower cholesterol, triglycerides, and blood pressure.8

Most notably, pomegranate has been shown to help prevent and even reverse some of the blood vessel damage that can lead to heart attack and stroke. 1,2,9,10

A clinical study in patients with atherosclerosis found that pomegranate consumption substantially decreased thickness of carotid artery plaques.9

Fresh pomegranate fruit or juice can be high in fructose.11 For those who want to avoid the sugar, pomegranate extracts provide an alternative.

A Nutritional Powerhouse

All parts of the pomegranate plant, including the fruit, leaves, peel, seeds, and flowers, are packed with beneficial compounds.

These include anthocyanins, flavonoids, and unique tannins (such as punicalagin).2

One of pomegranate’s most impressive effects is its ability to protect aging arteries in multiple ways, including preventing and even reversing endothelial dysfunction.1,2

Endothelial dysfunction refers to damage to the delicate inner lining of blood vessels. This dysfunction is an important contributor to atherosclerosis, the buildup of plaque in the arteries. 10,12

Atherosclerosis is responsible for a major share of deaths worldwide. 13,14

Improving Lipid Levels

Animal models have shown that pomegranate can reduce blood levels of total cholesterol, LDL cholesterol, and triglycerides.15-18

Oxidation of LDL cholesterol makes it more dangerous than normal LDL. Oxidized LDL accumulates in blood vessel walls more easily and accelerates the progression of atherosclerosis. Pomegranate decreases the oxidation of lipids.19,20

In human studies, pomegranate use significantly reduces blood levels of oxidized LDL and reduces LDL aggregation.19,21

Restoring Blood Vessel Function

An important indicator of endothelial dysfunction is an impaired ability of blood vessels to dilate (widen) when necessary.10,22

Pomegranate and its extracts improve the ability of the endothelium to promote arterial relaxation and dilation. 6,7

Nitric oxide is one of the body’s main vasodilators which means it induces the dilation of arteries.

In endothelial dysfunction, production of nitric oxide declines. Preclinical evidence shows that pomegranate can boost nitric oxide production and improve arterial dilation. 23-26

Preventing Blood Clots

Endothelial dysfunction and atherosclerosis increase the risk of abnormal blood clots.

Most heart attacks and strokes are caused by clots forming inside diseased arteries, which reduces blood flow to the heart or brain.27,28

Some of the same compounds contained in pomegranate that benefit arterial health also influence the function of platelets, the tiny cells in our blood that form clots.

Thromboxane A2, which is reduced by pomegranate, activates platelets and causes their aggregation.29,30

In animal studies, pomegranate reduced clotting associated with platelets and other factors, even when exposed to stimuli that would normally cause their aggregation.5,29

Improving Blood Pressure

High blood pressure is a major risk factor for atherosclerosis and is closely linked with endothelial dysfunction.31-33

A class of drug used to lower blood pressure are the ACE inhibitors.

Preclinical and clinical research has demonstrated that, like these medications, pomegranate extracts can inhibit ACE activity. 34,35 In fact, multiple clinical studies show that pomegranate is able to help reduce elevated blood pressure.8

In people with high blood pressure, two weeks of pomegranate intake decreased blood ACE activity by 36%. In this study, pomegranate lowered systolic blood pressure by 5%.35

In other human studies, pomegranate consumption led to reductions in systolic and diastolic blood pressure.8,36,37

In a study of subjects with atherosclerosis in the carotid artery, one year of pomegranate intake reduced systolic blood pressure by an average of 12%.9

Those with systolic blood pressure levels chronically above 115-120 mmHg should seek professional guidance on the appropriate medication and/or lifestyle intervention (such as weight loss) to safely achieve optimal blood pressure control.

Blood Glucose

Poor control of blood glucose levels is a powerful contributor to both endothelial dysfunction and to atherosclerosis.1

In animal studies, pomegranate extract improved insulin sensitivity and reduced fasting blood glucose levels.38,39

In studies of patients with type II diabetes or impaired glucose control, a single dose of pomegranate improved insulin sensitivity and blood glucose control.40,41

Pomegranate may also protect against the damage that glucose causes to tissues, including arteries. A large part of this damage is due to glycation, when sugars bind to proteins and alter their function.42

Punicalagin from pomegranate has been shown preclinically to suppress the glycation of proteins and prevent their accumulation, even in mice fed a high-sugar diet.43

Those with less-than-optimal glycemic markers (glucose + A1C + fasting insulin) despite healthy diet and lifestyle should seek professional guidance on a range of medications that can lower excess blood sugar.

What you need to know

Pomegranate Improves Endothelial Health

  • Heart disease is the most common cause of death worldwide.
  • Endothelial dysfunction, damage to the layer of cells lining the inside of arteries, is closely linked to atherosclerosis and risk for cardiovascular disease.
  • Pomegranate and its extracts contain many free-radical quenchers and anti-inflammatory nutrients that can shield against a wide range of chronic age-related cardiovascular risks.
  • Many of the health benefits of pomegranate are related specifically to blood vessel health, reducing the progression of endothelial dysfunction and atherosclerosis in animal and human studies. This reduces the risk of developing cardiovascular disease.
  • Even in subjects already experiencing signs of heart disease, pomegranate intake has been shown to reduce symptoms

Reducing Atherosclerotic Plaques

Pomegranate has a profound impact on blood vessel health.

In preclinical investigations, punicalagin and pomegranate extract have both been shown to help reverse endothelial dysfunction.44,45

Animal models of accelerated atherosclerosis also show that pomegranate can prevent and reverse the progression of atherosclerotic plaque.

For example, rodent studies show that pomegranate helped maintain arterial health and significantly slow progression of atherosclerosis.46,47 In a mouse study, pomegranate reduced the size of plaques by 44%. 21

Human trials have found striking effects on improving cardiovascular disease parameters.

One clinical study evaluated patients with atherosclerosis in the carotid arteries.9 Pomegranate consumption decreased the extent of atherosclerotic plaque by up to 35% after a year. Those who did not receive pomegranate had a 9% worsening of atherosclerosis.

In adults with ischemic heart disease (insufficient oxygen delivery and blood flow to the heart muscle), pomegranate significantly reduced the intensity, occurrence, and duration of angina (chest pain) episodes.48 It also lowered the level of troponin in the blood, an acute marker of damage to the heart muscle.

Another study in patients with heart disease found that while exercise-induced ischemia (reduced blood flow) of the heart increased in a control group over three months, patients receiving pomegranate juice had a significant ischemia decrease.49

These studies and others make it clear that pomegranate can help reduce risks for atherosclerosis and symptoms of heart damage in those with existing cardiac issues.


Pomegranate and its extracts have demonstrated abilities to prevent and reverse endothelial dysfunction, a blood vessel malfunction that contributes to atherosclerosis.

Pomegranate also improves blood pressure, glucose, lipid status, and abnormal clotting.

Through all these actions, pomegranate may reduce the risk of developing cardiovascular disorders and relieve symptoms in people with preexisting heart disease.

If you have any questions on the scientific content of this article, please call a Life Extension Wellness Specialist at 1-866-864-3027.


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