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5 Natural ACE Inhibitors: Health Effects & Limitations

Written by Mathew Eng, PharmD | Last updated:
Jonathan Ritter
Puya Yazdi
Medically reviewed by
Jonathan Ritter, PharmD, PhD (Pharmacology), Puya Yazdi, MD | Written by Mathew Eng, PharmD | Last updated:

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In recent years, scientists have found numerous natural compounds that potentially work like ACE inhibitors, a class of blood pressure-lowering drugs, but the research is still young. In this post, we focus on the five with the strongest clinical evidence.

Natural ACE Inhibitors

Please note: remember to speak with your physician before taking any supplements and let them know about all the supplements and over-the-counter drugs you are currently taking. They’re not meant to replace your medical treatment and may interact with certain drugs.

Preliminary research has identified different natural substances that may act as ACE inhibitors, but it doesn’t mean they are effective at reducing blood pressure. Further trials are needed to investigate their health effects.

Research is constantly discovering natural compounds that show promise in inhibiting angiotensin-converting enzyme (ACE), the same way that lisinopril and some other blood pressure-lowering meds work [1].

There is a database of potential natural ACE-inhibiting compounds that includes close to 6,000 entries. These compounds come from a huge variety of sources, like fish, mushrooms, dairy products, meat, and plants, to name a few [2].

The thing is, most of these natural compounds have not been studied in animals, let alone in humans and hence can’t be recommended for any health condition [1].

The following list includes the natural alternatives that have been best studied in clinical trials. Many of the studies focus on their effects on blood pressure.

1) Garlic

Research in cells and animals suggests that garlic may act as an ACE inhibitor, similar to lisinopril [3, 4].

Garlic also acts as an antioxidant, anti-inflammatory, and increases nitric oxide, all of which may help with heart health [5, 6, 7].

A recent review of 7 clinical trials analyzed garlic’s effect on blood pressure. They found that garlic, on average, reduces both systolic blood pressure (SBP – top number) and diastolic blood pressure (DBP – bottom number) by about 7 points [8].

Besides lowering blood pressure, research has uncovered additional heart-protective effects, including [9, 10, 11, 12]:

  • Reducing inflammation
  • Improving arterial stiffness
  • Lowering cholesterol
  • Preventing plaque buildup in arteries (atherosclerosis)

Did you know? Cooking garlic can inactive the beneficial compounds. This means raw garlic is more potent [13].

Also, the type of garlic can matter. Aged black garlic has stronger antioxidant effects compared to fresh, raw garlic. On the other hand, aged black garlic has lower anti-inflammatory, anti-blood clotting, and immune effects [14].

2) Whey Protein

Whey is a byproduct of the cheese-making process. It contains a mixture of proteins, vitamins, and minerals. Commonly used as a bodybuilding supplement, whey protein may improve heart health as well [15, 16].

Various proteins inside whey have demonstrated ACE inhibiting properties [17, 18, 19].

Whey protein decreases SBP by ~4 points and DBP by 2.5 points, based on a small clinical trial of 38 people. Other studies have found similar blood pressure lowering effects [20, 21, 22].

On top of that, a review of 9 clinical trials looked at whey protein’s effect on overweight and obese patients. They found improvements in body weight, cholesterol, and blood pressure, all of which are risk factors for heart disease [23].

3) Casein

Similar to whey protein, casein is a byproduct of cheese production. Casein is also rich in proteins and nutrients, but the amino acids found inside are different from whey [24].

Research has identified several peptides inside casein that can block ACE [25, 26].

One review examined 30 different clinical trials that used casein. On average, it lowered SBP by 3 points and DBP by 1.5. Interestingly, this effect was stronger in Japanese individuals and weaker in Europeans [27].

Another study found that calcium caseinate (one of the compounds inside casein) slightly reduces triglycerides after a meal [28].

4) Pycnogenol

Pycnogenol is the brand name of a supplement made from extracts of the French maritime pine bark. It contains 65-75% procyanidins, compounds with antioxidant and anti-inflammatory effects [29].

Pycnogenol works in several different ways, including ACE inhibition. It also increases nitric oxide, which helps relax blood vessels [30].

A large review of 9 clinical trials analyzed Pycnogenol’s effect on blood pressure. On average, it reduces both SBP and DBP (bottom and top number) by about 3 points. This effect is even greater in those that took supplements for more than 12 weeks [31].

Though it is important to note that many of these trials were sponsored by the manufacturer of the supplement, so there is a potential for bias in these studies.

Another small study of 55 people looked at the effects of Pycnogenol combined with ramipril, an ACE-inhibitor similar to lisinopril. They found that this combination lowers blood pressure better than ramipril alone. The combination also improved kidney flow and function [32].

Pycnogenol may also reduce swelling (edema) caused by nifedipine, a blood pressure-lowering medication. This effect protects blood vessels from injury and may help patients reduce the dosage of their medications [33].

5) Pomegranate

Pomegranate fruit has several surprising health benefits, including potential heart-protective effects [34].

Both the peel and juice of pomegranate can block ACE activity, much like lisinopril [35, 36].

One review analyzed 8 clinical trials and found that pomegranate juice reduces SBP by 5 points and DBP by 2 points [37].

Punicic acid, a compound inside pomegranate seed oil, may also prevent plaque buildup in blood vessels (atherosclerosis). A small study of 50 people demonstrated that pomegranate seed oil can lower triglyceride levels [38].

Once again, the above foods and substances are not meant to replace your medical treatment. Taking them in significant amounts may require adjusting the dosage of your medications, which you shouldn’t do on your own. Make sure to speak with your doctor before making any major changes to your day-to-day routine.

About the Author

Mathew Eng

Mathew Eng

PharmD
Mathew received his PharmD from the University of Hawaii and an undergraduate degree in Biology from the University of Washington.
Mathew is a licensed pharmacist with clinical experience in oncology, infectious disease, and diabetes management. He has a passion for personalized patient care and believes that education is essential to living a healthy life. His goal is to motivate individuals to find ways to manage their chronic conditions.

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