Does bitter orange increase blood pressure?

    Last Updated: October 25, 2023

    Some limited research suggests that bitter orange supplements may increase blood pressure, while other research found no effect. A meta-analysis of small randomized controlled studies suggests that taking bitter orange extract alone or with other ingredients for 56–60 days increases systolic blood pressure by up to 6.4 mmHg compared to control; however, there was no significant effect on diastolic blood pressure. Acute administration of bitter orange extract tended to increase blood pressure over 3 hours, but this result was not statistically significant.[1] One randomized crossover trial of 15 healthy, young adults given a single dose of bitter orange supplement containing 108 mg of synephrine, which was included in the above meta-analysis, reported that the participants given synephrine experienced modestly increased blood pressure and heart rate for up to 5 hours compared to placebo.[2] In another small study, in which participants were given a single, smaller dose of 27 mg of synephrine and monitored for 8 hours, no significant difference from placebo was seen on t blood pressure or electrocardiogram (QT interval).[3] In a small study of healthy young adults sitting quietly for 3 hours after taking a single dose of 103 mg p-synephrine, alone or with 240 mg caffeine, blood pressure and heart rate were not affected compared to placebo.[4] These results suggest that caffeine and synephrine may not always have synergistic effects in the short term.

    A small study of 10 healthy adults considered 2 different dietary supplements containing synephrine and compared heart rate and blood pressure results with placebo after a single dose (Advantra Z, containing 46.9 mg synephrine, and Xenadrine EFX, containing 5.5 mg synephrine). Interestingly, the Xenadrine EFX group experienced more blood pressure and heart rate elevations than the Advantra group, possibly due to other ingredients in the supplement.[5]

    The longer-term effects of a 20 mg daily dose of synephrine were examined in an 8 week study of healthy, young, resistance-trained males; researchers found no changes in blood pressure or heart rate compared to control.[6].

    References

    1. ^Koncz D, Tóth B, Bahar MA, Roza O, Csupor DThe Safety and Efficacy of (Bitter Orange) Extracts and -Synephrine: A Systematic Review and Meta-Analysis.Nutrients.(2022-Sep-28)
    2. ^Bui LT, Nguyen DT, Ambrose PJBlood pressure and heart rate effects following a single dose of bitter orangeAnn Pharmacother.(2006 Jan)
    3. ^Min B, Cios D, Kluger J, White CMAbsence of QTc-interval-prolonging or hemodynamic effects of a single dose of bitter-orange extract in healthy subjectsPharmacotherapy.(2005 Dec)
    4. ^Ratamess NA, Bush JA, Stohs SJ, Ellis NL, Vought IT, O'Grady EA, Kuper JD, Hasan SB, Kang J, Faigenbaum ADAcute cardiovascular effects of bitter orange extract (p-synephrine) consumed alone and in combination with caffeine in human subjects: A placebo-controlled, double-blind study.Phytother Res.(2018-Jan)
    5. ^Haller CA, Benowitz NL, Jacob PHemodynamic effects of ephedra-free weight-loss supplements in humans.Am J Med.(2005-Sep)
    6. ^Jung YP, Earnest CP, Koozehchian M, Cho M, Barringer N, Walker D, Rasmussen C, Greenwood M, Murano PS, Kreider RBEffects of ingesting a pre-workout dietary supplement with and without synephrine for 8 weeks on training adaptations in resistance-trained males.J Int Soc Sports Nutr.(2017)