Effects of pomegranate on blood pressure and endothelial function: A systematic review and meta-analysis of clinical trials

Abstract

This systematic review and meta-analysis evaluated pomegranate supplementation effects on blood pressure and endothelial function in adults. Four main databases, including PubMed/MEDLINE, Web of Science, SCOPUS, and Embase databases, were searched from inception to January 2026 to identify clinical trials. The pooled weighted/standardized mean differences (WMDs/SMDs) and 95 CIs were computed using the random-effects model. The Findings from 33 studies indicated significant reductions in systolic blood pressure (WMD: -3.52 mmHg; 95 CI: -4.97 to -2.06; P < 0.001), diastolic blood pressure (WMD: -1.50 mmHg; 95 CI: -2.58 to -0.42; P = 0.006), interleukin (IL)-6 (SMD: -0.82; 95 CI: -1.29 to -0.35; P = 0.001), and intercellular adhesion molecule 1 (ICAM-1) levels (SMD: -0.59; 95 CI: -0.97 to -0.22; P = 0.002). However, analysis indicated a nonsignificant effect on vascular cell adhesion protein 1 (VCAM-1), and E-selectin. In conclusion, it appears that pomegranate can lead to significant improvements in blood pressure, IL-6, and ICAM-1 levels. Future studies are needed to investigate the effect of pomegranate on blood pressure and endothelial function in adults.