Blood Pressure-Lowering Peptides From Fermented Milk: How Yogurt and Cheese Make Natural ACE Inhibitors | Research

The takeaway

Fermented milk products like yogurt and cheese naturally produce ACE-inhibitory peptides during fermentation that survive digestion and have been shown to reduce blood pressure in animal and human studies.

Resistant to GI digestion
Many ACE-inhibitory peptides from fermented milk survive stomach acid and digestive enzymes to reach their target in active form

What the researchers found

ACE-inhibitory peptides produced during milk fermentation are resistant to gastrointestinal digestion and can inhibit ACE in the renin-angiotensin system in their intact form. Their production and potency depend on multiple factors: the type of starter culture (lactic acid bacteria species, yeast), the milk protein substrate (casein type, whey protein), the specific peptide composition, and pre- and post-fermentation processing.

The antihypertensive effects of fermented milk products have been confirmed through in vitro studies, animal models, and human clinical trials. Several ACE-inhibitory peptides from fermented milk are now available in commercial products marketed for blood pressure support.

Why it matters

Hypertension affects over a billion people worldwide and is the leading risk factor for cardiovascular disease. While pharmaceutical ACE inhibitors are effective, they have side effects. Food-derived bioactive peptides offer a complementary approach — potentially preventing hypertension or reducing medication burden through everyday foods. Understanding what makes these peptides effective can guide the development of optimized functional dairy products.

How the study worked

Comprehensive narrative review of published literature on ACE-inhibitory peptides from fermented milk, covering peptide identification, production factors, gastrointestinal stability, and evidence from in vitro, animal, and human studies.

What this study cannot tell us

As a review, no new experimental data are presented. The blood pressure-lowering effects seen in clinical trials are generally modest compared to pharmaceutical ACE inhibitors. Bioavailability varies significantly between peptides and between individuals. Not all fermented milk products contain therapeutic concentrations of ACE-inhibitory peptides. The review does not comprehensively address dose-response relationships or long-term efficacy.

How to read the evidence

This is a narrative review summarizing evidence from multiple levels: in vitro ACE inhibition assays, animal models, and human clinical trials. While the breadth of evidence is strong, the review itself is not a systematic review or meta-analysis, and effect sizes in humans are generally modest.

When this study was published

Published in 2017, this review covers a well-established field. The fundamental science of milk-derived ACE-inhibitory peptides has not changed significantly since publication, though new starter cultures and processing methods continue to be explored.

The bigger picture

Food-derived bioactive peptides are one of the most mature areas of functional food research. ACE-inhibitory peptides from milk were among the first to be commercialized (notably in products like Calpis and Evolus), and they established the proof of concept that food peptides can have clinically meaningful physiological effects. This work has paved the way for the broader bioactive peptide field, including peptides from fish, soy, and other protein sources.

Questions still open

Can fermented milk ACE-inhibitory peptides meaningfully reduce blood pressure in patients already on antihypertensive medication?
Which specific lactic acid bacteria strains produce the most potent and bioavailable ACE-inhibitory peptides?
Could these natural peptides serve as a preventive strategy for pre-hypertensive individuals to delay or avoid the need for medication?

Common questions

Can eating yogurt actually lower blood pressure?

Yes, to a modest degree. Multiple human studies have shown that fermented milk products containing ACE-inhibitory peptides can reduce blood pressure, though the effect is smaller than prescription medications. The peptides work by the same mechanism as ACE inhibitor drugs — blocking the enzyme that raises blood pressure — but at lower potency. Regular consumption may be most useful for people with mildly elevated blood pressure or as a complement to medication.

How do these milk peptides survive being digested?

Not all bioactive peptides survive digestion, but many of the ACE-inhibitory peptides found in fermented milk are resistant to breakdown by stomach acid and digestive enzymes. Their small size and specific amino acid sequences protect them from being destroyed, allowing them to be absorbed into the bloodstream and reach the ACE enzyme in active form. This digestive resistance is a key factor researchers consider when evaluating which peptides are most promising.

Read the original research

Production of angiotensin I converting enzyme inhibitory (ACE-I) peptides during milk fermentation and their role in reducing hypertension.

Critical reviews in food science and nutrition, 57(13), 2789-2800

View on PubMed ↗Publisher’s paper ↗

Citation

Rai, Amit Kumar; Sanjukta, Samurailatpam; Jeyaram, Kumaraswamy. (2017). Production of angiotensin I converting enzyme inhibitory (ACE-I) peptides during milk fermentation and their role in reducing hypertension.. Critical reviews in food science and nutrition, 57(13), 2789-2800. https://doi.org/10.1080/10408398.2015.1068736