Can NAD+ lower blood pressure? The short, honest answer is that it might modestly in some people, but the evidence is early and NAD+ is not a treatment for high blood pressure. One small pilot trial found lower systolic blood pressure in participants whose readings were already above normal, but the finding came from an exploratory subgroup analysis and needs to be confirmed in larger trials.

NAD+ Key Takeaways

• NAD+ is a coenzyme found in every cell in the body. It helps cells turn food into usable energy and supports enzymes involved in DNA repair.
• In a six-week pilot trial in healthy adults aged 55 to 79, the NAD+ precursor nicotinamide riboside raised blood NAD+ by about 60 percent and was well tolerated.
• In that trial, systolic blood pressure fell by roughly 8 to 10 mmHg in the 13 participants who started with readings in the elevated or stage 1 hypertension range. In the group as a whole, the change was not statistically significant.
• No NAD+ product is authorized in Canada to treat, prevent, or manage high blood pressure. Hypertension sits on Schedule A to the Food and Drugs Act, which restricts what may be said about it to the public.
• Sodium reduction, regular activity, weight management, limiting alcohol, and prescribed medication remain the approaches with the strongest evidence.

What NAD+ Actually Is

NAD+ stands for nicotinamide adenine dinucleotide. It is a coenzyme, which means it is a helper molecule that other enzymes need in order to work. Its main job is shuttling electrons during the reactions that convert food into ATP, the fuel your cells run on.

NAD+ also acts as a substrate for two families of enzymes that matter in aging research. Sirtuins use NAD+ to regulate gene activity and mitochondrial function. PARPs use NAD+ during DNA repair. Both draw down the available NAD+ pool when they are busy.

Your body makes NAD+ from a few starting materials, all members of the vitamin B3 family:

• Nicotinamide riboside (NR), the precursor used in most cardiovascular research to date
• Nicotinamide mononucleotide (NMN), one step closer to NAD+ in the pathway
• Nicotinic acid (niacin) and nicotinamide, the traditional forms of vitamin B3

In Canada, NMN is sold as a licensed natural health product. Health Canada licence NPN 80121612, for example, permits claims only along the lines of a source of vitamin B3, a factor in the maintenance of good health, an antioxidant, and a NAD+ precursor that acts as a cofactor in energy metabolism.

Blood pressure is not among the permitted claims, and it could not be, because hypertension is listed in Schedule A to the Food and Drugs Act. Section 3 of that Act prohibits advertising any drug or natural health product to the general public as a treatment or cure for a Schedule A disease.

Does NAD+ Really Fall as You Age?

You will see this stated as settled fact in a lot of marketing. It is less settled than it looks.

Direct tissue measurements do show a decline in some tissues. A 2012 study measured NAD+ in non-sun-exposed skin from 49 people aged newborn to 77 and found a strong negative correlation between NAD+ and age. Brain imaging studies have found similar patterns.

A 2025 review in Nature Metabolism, however, concluded that consistent human evidence for an age-related NAD+ decline comes from a limited number of studies and that the pattern is not uniform across tissues. Some tissues show no decline at all.

The reasonable position: NAD+ appears to decline with age in several human tissues, the size of that decline is not well established, and blood levels do not necessarily reflect what is happening inside muscle, brain, or vessel wall tissue.

Can NAD+ Lower Blood Pressure? What the Trials Show

Does NAD+ lower blood pressure, then? Here is what the trials show. The most cited human trial here was published in Nature Communications in 2018 by Martens and colleagues at the University of Colorado Boulder.

The design was a randomized, double-blind, placebo-controlled crossover trial. Thirty healthy middle-aged and older adults, aged 55 to 79, took either 1,000 mg of nicotinamide riboside daily or a placebo for six weeks, then switched. Twenty-four completed both arms.

Three findings from this study stood out:

1. It raised NAD+. Whole blood NAD+ rose about 60 percent on nicotinamide riboside. That confirmed the supplement does what it is supposed to do biochemically.
2. It was well tolerated. No serious adverse effects were reported over the six weeks.
3. Blood pressure moved, but only clearly in one subgroup. Across the whole group, systolic pressure and aortic stiffness both trended downward without reaching statistical significance. In the 13 participants who started with readings between 120 to 139 systolic or 80 to 89 diastolic, systolic pressure was roughly 8 to 10 mmHg lower after supplementation.

The researchers were careful about how they framed this. They described the study as small and pilot in nature, said they could not make definitive claims about safety or effectiveness for any specific population, and called for larger trials.

That is exactly what followed. A three-month randomized trial in adults aged 50 and over with systolic pressure at or above 120 mmHg was registered and run. Results presented at a 2025 physiology conference reported that nicotinamide riboside raised NAD+ availability, lowered resting systolic pressure, and improved blood vessel lining function, with no serious adverse events. That presentation has not yet been published as a peer-reviewed paper, so it should be treated as promising rather than confirmed.

How NAD+ Might Affect Blood Vessels

The proposed mechanism is reasonable, which is part of why the research continues. Here is how NAD+ might affect blood vessels.

Systolic blood pressure tends to rise with age largely because the large elastic arteries stiffen. That stiffening is driven by oxidative stress, low-grade inflammation, and increased tone in the smooth muscle of the vessel wall.

The endothelium, the single-cell layer lining every blood vessel, produces nitric oxide, a signalling molecule that tells vessels to relax. Oxidative stress interferes with nitric oxide availability.

In laboratory studies, compounds that raise NAD+ levels have been shown to help blood vessel cells produce more nitric oxide, a molecule that helps blood vessels relax and supports healthy blood flow. They may also help protect these cells from oxidative stress, a type of cellular damage that increases with age. Animal studies have found that NAD+ precursors improve vessel function in older mice.

So the chain of reasoning runs: more NAD+, better mitochondrial and antioxidant function in the vessel wall, more available nitric oxide, more relaxed and less stiff arteries, lower systolic pressure. Each link has support. The whole chain has not been demonstrated end to end in a large human trial.

What People Also Want to Know About NAD+ and Blood Pressure

Is NAD+ a Proven Treatment for Hypertension?

No. No NAD+ product is authorized in Canada for the treatment, prevention, or management of high blood pressure, and the human evidence base is one small pilot trial plus preliminary results from a second.

Health Canada lists hypertension in Schedule A to the Food and Drugs Act, so a natural health product cannot be advertised to the public as a treatment or cure for it. Anyone selling NAD+ as a blood pressure treatment is ahead of both the science and the rules.

Are There Other Cardiovascular Benefits?

Aortic stiffness, measured by carotid-femoral pulse wave velocity, also trended lower in the 2018 pilot. Arterial stiffness independently predicts cardiovascular risk, so that signal is interesting. It is a secondary finding from a 24-person study, not a reason to change anything about your care.

What Are Some Natural Ways to Support Healthy Blood Pressure?

High blood pressure is common in Canada. Statistics Canada data from 2016 to 2019 found that 23 percent of Canadian adults aged 20 to 79 had stage 2 hypertension, either measured, diagnosed, or treated with medication. Among adults aged 60 to 79 that figure was 51 percent. A further 14 percent had measured readings equivalent to stage 1.

Here are some natural ways to support healthy blood pressure. These approaches have far more evidence behind them than any supplement:

• Reduce sodium. Most of it comes from packaged and restaurant food, not the shaker.
• Move regularly. Aerobic activity most days, with resistance training alongside it.
• Manage weight where that applies, since even modest loss shifts blood pressure.
• Limit alcohol.
• Prioritize sleep and treat sleep apnea if it is present.
• Increase potassium-rich foods such as vegetables, fruit, and legumes, unless a clinician has told you otherwise because of kidney function or medication.

How Does This Compare with Established Treatment?

For someone with diagnosed hypertension, antihypertensive medication has decades of outcome data behind it, including reductions in stroke and heart attack. NAD+ has a single positive subgroup finding in a pilot trial. Those are not comparable levels of evidence, and it would be a mistake to substitute one for the other.

The population where NAD+ research is most interesting is different: adults whose readings are above normal but not yet high enough to warrant medication. That is the group the Colorado team specifically pointed to, and it is the group the follow-up trial enrolled.

Safety Regarding NAD+ and Who Should Speak with a Healthcare Provider First

Nicotinamide riboside has been tolerated well in trials, including at 2,000 mg daily for 12 weeks. A separate trial found 1,250 mg of NMN daily for four weeks was tolerated in healthy adults. Reported side effects across trials have generally been mild.

Even so, a few situations call for a conversation with a clinician before you start, which includes if:

• You take blood pressure medication. No trial has tested NAD+ precursors alongside antihypertensives. If a supplement does lower your pressure and your medication is already doing so, the combined effect has not been studied. Never adjust or stop prescribed medication on your own.
• You have kidney or liver disease, or you are pregnant or breastfeeding. These groups were excluded from the trials.
• You are considering high-dose niacin. Nicotinic acid is a different molecule with different effects, including flushing and effects on blood sugar and liver enzymes at pharmacological doses. Research on nicotinamide riboside does not transfer to it.
• Your readings are already high. Elevated blood pressure often produces no symptoms at all, which is why measurement matters. If you have not had yours checked recently, start there.

If you are curious whether NAD+ fits into your own approach to healthy aging, a licensed clinician can review your health history and current medications and tell you whether it makes sense in your situation.

Additionally, you can read more in our guide to NAD injections in Canada and our overview of longevity supplements that hold up to scrutiny.

Frequently Asked Questions

Can NAD+ Lower High Blood Pressure Naturally?

There is preliminary evidence that NAD+ might help lower high blood pressure modestly. In one pilot trial, participants with elevated or stage 1 readings saw systolic pressure fall by roughly 8 to 10 mmHg on nicotinamide riboside. That result came from 13 people and needs confirmation in larger trials before anyone can call it a natural blood pressure solution.

Does NAD+ Help Hypertension?

NAD+ does not help hypertension in any established sense.

Note: NAD+ is not authorized in Canada for hypertension, and no completed peer-reviewed trial has shown it reduces cardiovascular events.

Research is active, particularly in adults whose readings are above normal but not yet in the treatment range.

Is NAD+ Good for Heart Health?

The mechanism is plausible and early findings on blood pressure and arterial stiffness are encouraging. Plausible is not the same as proven. Treat NAD+ as an area of active research rather than a heart health intervention.

What Does NAD+ and Hypertension Research Currently Show?

One small crossover trial found a subgroup benefit in systolic pressure.

A larger three-month trial in adults with above-normal systolic pressure has reported positive preliminary results at a conference, not yet in a peer-reviewed journal.

That is the entire human evidence base at present.

Is NAD+ Safe for People with Hypertension?

Trials have found NAD+ precursors well tolerated in healthy adults, but people on blood pressure medication were not the study population. Because a possible additive effect on blood pressure has not been studied, speak with your prescriber first.

How Does NAD+ Affect Blood Vessels and Circulation?

NAD+ supports mitochondrial function and antioxidant defences in the cells lining your blood vessels. Better function there means more available nitric oxide, the signal that tells vessels to relax. Laboratory and animal work supports this. Human confirmation is limited.

What NAD+ Research Could Mean for Heart Health

NAD+ research offers an intriguing window into how aging may affect cardiovascular health, from the function of our blood vessels to the way our bodies regulate blood pressure. Early findings suggest that supporting NAD+ levels could eventually play a role in healthy cardiovascular aging, but the research is still developing. For now, the best approach is to stay curious without getting ahead of the science: know your blood pressure, prioritize the strategies already proven to protect your heart, and think of NAD+ as a potential complement to those foundations, not a replacement for them.

Curious whether NAD+ fits your health goals? A licensed MyRocky clinician will review your history and tell you what makes sense for you.

Start a Free Online Assessment

References

1. Martens CR, Denman BA, Mazzo MR, et al. “Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults.” Nature Communications, 2018;9:1286.
2. Health Canada. “Guidance Document: Schedule A and Section 3 to the Food and Drugs Act.” Health Products and Food Branch, effective 19 December 2013.
3. Health Canada. “Licensed Natural Health Products Database, product licence NPN 80121612 (nicotinamide mononucleotide), permitted uses and risk information.“
4. Massudi H, Grant R, Braidy N, et al. “Age-associated changes in oxidative stress and NAD+ metabolism in human tissue.” PLOS ONE, 2012;7(7):e42357.
5. Statistics Canada. “Blood pressure of adults, 2016 to 2019.” Health Fact Sheets, Catalogue no. 82-625-X, 2021.

Disclaimer: This article is intended for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your healthcare provider with any questions about a medical condition or treatment.

Editorial Standards: At Rocky Health, we’ve made it our mission to support men and women with trustworthy, easy-to-understand medical and health information online. Read more about our editorial standards here.