Cardiovascular disease remains one of the most prevalent diseases in the United States and has remained as the leading cause of death. Large Mendelian randomization studies have found significant correlations between high blood pressure and cardiovascular disease (CVD). In fact, high blood pressure is the single most important independent risk factor for CVD. The purpose of this study was to determine the effect of L-citrulline on blood pressure to determine whether it could be advised as an effective treatment for high blood pressure. L-citrulline is a naturally occurring amino acid that readily converts to L-arginine within the human body. L-arginine has shown promise in decreasing both systolic blood pressure (SBP) and diastolic blood pressure (DBP) significantly by potently increasing levels of nitric oxide (NO) in the body. L-arginine, however, displays poor oral bioavailability compared to L-citrulline. Thus, L-citrulline may be a more effective method in raising plasma arginine levels, increasing NO, and decreasing SBP and DBP. A thorough systematic review and meta-analysis was conducted to extrapolate this effect. Using online databases, hundreds of articles were screened, and ultimately 11 studies were chosen, encompassing 224 total participants. Results showed an overall significant effect of L-citrulline on both resting SBP (MD: -3.74; 95% CI [-6.74, -0.74]; p=0.01) and DBP (MD: -2.00; 95% CI [-3.93, -0.06]; p=0.04). Further analysis of funnel plots was used to determine publication biases and subgroup analysis was performed to determine specific trial moderators that could have affected the overall outcome. In most cases, L-citrulline displayed a significant effect on blood pressure, and more research is warranted to investigate its potential therapeutic effect on cardiovascular health.

Thesis Completion




Thesis Chair/Advisor

Gupta, Manish


Bachelor of Science (B.S.)


College of Medicine


Burnett School of Biomedical Sciences



Access Status

Open Access

Release Date