Nutrition Research · Nov 2026
Potential Vascular Mechanisms Underlying the Antihypertensive Effects of Blueberries: A Narrative Review
By Najjar RS, Wainford RD, Mehta PK et al.
Hypertension increases the risk of cardiovascular disease-related mortality, and this condition affects half of those in the United States. There are multiple mechanisms that contribute to hypertension, but compromised vascular function is a key underlying factor in hypertension, mediated by endothelial and vascular smooth muscle cell dysfunction. Blueberries, due to their high polyphenol content and distinctive polyphenol profile, have emerged as a promising dietary strategy for improving vascular function. Clinical studies indicate that blueberry consumption can reduce blood pressure or improve vascular function in individuals with elevated blood pressure or stage 1 hypertension. Despite these favorable hemodynamic observations, the underlying physiological and cellular mechanisms responsible for these effects remain poorly defined. Thus, the aim of this review is to highlight potential mechanisms through which blueberry-derived polyphenols may beneficially modulate vascular function to reduce blood pressure in hypertension. Blueberries may: 1) alter the gut microbiota to favorably reduce blood pressure, 2) downregulate the renin-angiotensin-aldosterone system (RAAS), 3) favorably modify estrogen receptor activity, 4) reduce vascular inflammation and oxidative stress, 5) favorably modify prostaglandin metabolism, and 6) reduce mitochondrial dysfunction. Further research, particularly in clinical settings, is needed to validate the pathways through which blueberry consumption may contribute to blood pressure regulation.