Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Nicotinamide riboside (NR) is a form of vitamin B3 that serves as a precursor to nicotinamide adenine dinucleotide (NAD+), an essential molecule involved in cellular metabolism and mitochondrial function. There is increasing scientific interest in NAD+ precursors for cardiovascular health, including congestive heart failure (CHF), but the evidence remains preliminary. Preclinical studies in animal models of heart failure have shown that supplementation with NR can increase myocardial NAD+ levels, improve mitochondrial function, and reduce markers of cardiac dysfunction. For example, a 2019 study in mice published in Circulation demonstrated that NR supplementation improved cardiac function and remodeling in heart failure models. The proposed mechanisms include enhanced mitochondrial biogenesis, reduced oxidative stress, and improved energy metabolism—all of which are impaired in CHF. In humans, direct evidence is limited. A few small clinical trials have shown that NR supplementation is safe and increases NAD+ levels, but robust data on clinical endpoints such as cardiac function, quality of life, or mortality in CHF patients are lacking. Ongoing trials (as of 2024) are investigating these outcomes, but currently, most recommendations for NR in CHF are based on mechanistic rationale and animal data rather than definitive human evidence. Thus, while there is scientific interest and some early validation, the strength of evidence supporting NR for CHF remains modest at this time.

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