NutriStack
Pine Bark Extract and Ramipril, a synergy.
Pine Bark Extract (Pycnogenol) lowers blood pressure (about 3 mm Hg systolic and 3 mm Hg diastolic in a meta-analysis) and has independent ACE-inhibitory activity. Two trials specifically tested it as an adjunct to ramipril in hypertensive patients and reported significantly greater blood pressure reduction than ramipril alone. The combination is well tolerated.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Substances
- Pine Bark Extract and Ramipril
- Pair type
- Synergy
- Evidence (highest tier)
- Moderate
- Source citations
- 1 source
- Stack Score effect
- +2 to your Stack Score (per scored synergy row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Synergy · Moderate evidence
Synergy
What is happening. Pine Bark Extract (Pycnogenol) lowers blood pressure (about 3 mm Hg systolic and 3 mm Hg diastolic in a meta-analysis) and has independent ACE-inhibitory activity. Two trials specifically tested it as an adjunct to ramipril in hypertensive patients and reported significantly greater blood pressure reduction than ramipril alone. The combination is well tolerated.
Mechanism. Pine bark procyanidins inhibit ACE in vitro and increase endothelial nitric oxide production. Direct adjunct trials with ramipril show clinically meaningful additive blood pressure reduction.
Recommendation. Pine Bark Extract 100-200 mg/day is a typical research dose; monitor home blood pressure after starting and tell your prescriber so your ramipril dose can be reviewed. Mild hypotension is possible if BP is already at goal.
Stack Score
How this pair moves the number.
Effect on the composite score
If both Pine Bark Extract and Ramipril are in the same stack, this pair applies +2 to your Stack Score (per scored synergy row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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