Bitter Orange and cardiovascular safety

What 3 graded rows on bitter orange agree on for cardiovascular safety, and where they differ. Counted side by side, never averaged.

Consensus finder Rows from the Bitter Orange page, reviewed Oct 21, 2026 How it decides

What the rows agree on

Each block and row is one graded row from the Bitter Orange page, with its PubMed record.

Supplement

Bitter Orange Choose another

3 rows · 253 people

Mostly a worse outcome: 2 of 3 rows, and most of the people. 1 found no difference.

No difference or worse

Improved

Each block is one evidence row, sized by how many people it enrolled, with its grade inside. Red: a worse outcome.

From the rows

Trial sizeStudy designGrade

The best-graded row, grade C, is a meta-analysis of 222 people (2022) and found a worse outcome.

The 2 rows that found a worse outcome were larger: a median of 119 people, against 16 people for the row that found no difference.

Only the 2 rows that found a worse outcome include pooled reviews of several trials (1 of 2); the row that found no difference is a single study.

The best grade is C among the rows that found a worse outcome, and D among the row that found no difference.

1 no difference · 2 worse

Grade CBlood pressure and heart rate (harm) · Worse
Meta-analysis, 11 studies · n 222 · 2022 · Adults in 11 placebo-controlled trials
10–214 mg p-synephrine · Single doses to prolonged use
After prolonged use, systolic blood pressure rose 6.37 mmHg and diastolic 4.33 mmHg versus placebo; the authors conclude synephrine tends to raise blood pressure and heart rate.
Row on the Bitter Orange page · PubMed 36235672 (opens PubMed)
Grade DBlood pressure and heart rate after a single dose (harm) · Worse
Crossover RCT · n 15 · 2006 · Young healthy adults
Single 900 mg dose (about 54 mg synephrine) · Single dose, measured hourly for 6 hours
Versus placebo, systolic pressure was higher at hours 1–5 (peak difference 7.3 mmHg), diastolic at hours 4–5 (peak 2.6 mmHg) and heart rate at hours 2–5 (peak 4.2 beats/min).
Row on the Bitter Orange page · PubMed 16317106 (opens PubMed)
Grade DHeart rate, blood pressure and ECG over 15 days · No difference
Crossover RCT · n 16 · 2018 · Healthy adults
49 mg/day p-synephrine · 15 days
No significant changes in heart rate, ECG, systolic or diastolic pressure, blood counts or chemistries, and no adverse effects reported.
Row on the Bitter Orange page · PubMed 29130542 (opens PubMed)