Limited evidence. Direction: Benefit.
C LimitedShort-term only
Rubric condition met: Two meta-analyses of NMN find a small diastolic reduction and no systolic effect; NR trials are null or not significant. Not B under the rubric: results mixed by measure and by precursor
NMN only: NR trials were not significant. A 2026 meta-analysis of 10 RCTs (349 adults without cardiovascular disease or diabetes, mostly with above-normal blood pressure) found NMN was associated with a modest 2.15 mmHg reduction in resting diastolic pressure compared with placebo, with no significant change in systolic pressure overall; the authors call the evidence preliminary. A second 2026 meta-analysis found a slight diastolic decrease and no systolic effect. For NR, a 6-week crossover trial found a non-significant downward trend, a 6-week trial combined with exercise was not superior to exercise alone, and a 6-week crossover found no effect on ambulatory blood pressure. The diastolic signal for NMN is small and short-term, so C.
| Study | Year | Design | Participants | Result |
|---|---|---|---|---|
| Martens 2018 | 2018 | crossover RCT | 24 | result not recorded |
| Remie 2020 | 2020 | crossover RCT | 13 | result not recorded |
| Katayoshi 2023 | 2023 | RCT | 36 | result not recorded |
| Pencina 2023 | 2023 | RCT | 30 | result not recorded |
| Oliveira-Cruz 2024 | 2024 | meta-analysis | not recorded | result not recorded |
| Lin 2025 | 2025 | RCT | 54 | result not recorded |
| Yang 2026 | 2026 | meta-analysis | not recorded | result not recorded |
| Zhang 2026 | 2026 | meta-analysis | 349 | result not recorded |
Oliveira-Cruz A, Macedo-Silva A, Silva-Lima D. Effects of Supplementation with NAD + Precursors on Metabolic Syndrome Parameters: A Systematic Review and Meta-Analysis Horm Metab Res, 2024. PMID 39111741
Katayoshi T, Uehata S, Nakashima N. Nicotinamide adenine dinucleotide metabolism and arterial stiffness after long-term nicotinamide mononucleotide supplementation: a randomized, double-blind, placebo-controlled trial Sci Rep, 2023. PMID 36797393
Remie CME, Roumans KHM, Moonen MPB. Nicotinamide riboside supplementation alters body composition and skeletal muscle acetylcarnitine concentrations in healthy obese humans Am J Clin Nutr, 2020. PMID 32320006
Lin Y, Zeidan RS, Lapierre-Nguyen S. Nicotinamide riboside combined with exercise to treat hypertension in middle-aged and older adults: a pilot randomized clinical trial Geroscience, 2025. PMID 40770531
Martens CR, Denman BA, Mazzo MR. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD(+) in healthy middle-aged and older adults Nat Commun, 2018. PMID 29599478
Yang W, Huang J, Tang Z. Safety and Metabolism-Related Outcomes of Oral Nicotinamide Mononucleotide Supplementation in Adults: A Systematic Review and Meta-Analysis Nutrients, 2026. PMID 42514320
Zhang M, Chen Y, Jiang N. Effects of Nicotinamide Mononucleotide Supplementation on Blood Pressure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Nutrients, 2026. PMID 41901064
Pencina KM, Valderrabano R, Wipper B. Nicotinamide Adenine Dinucleotide Augmentation in Overweight or Obese Middle-Aged and Older Adults: A Physiologic Study J Clin Endocrinol Metab, 2023. PMID 36740954
Search (): (nicotinamide mononucleotide[tiab] OR nicotinamide riboside[tiab]) AND ("blood pressure"[tiab] OR "arterial stiffness"[tiab]) AND clinical trial[pt]
