Psychological Dependence on Long-Term Nitric Oxide-Boosting Supplement Use Among Athletes and Its Potential Impacts on Cardiovascular Health Risks

Abstract

Nitric oxide (NO)-boosting supplements are widely used by athletes in China for enhancing endurance, improving blood flow, and accelerating recovery. Containing L-arginine, L-citrulline, and dietary nitrates, these supplements promote oxygen delivery and delay fatigue. However, concerns over psychological dependence, cardiovascular risks, and metabolic adaptation raise questions about their long-term safety.
This study explores NO supplementation mechanisms, physiological effects, and associated risks. While short-term use enhances vasodilation and endurance capacity (5-8%), prolonged reliance may disrupt blood pressure regulation, induce NO tolerance, and impair endothelial function. Psychological dependence can further lead athletes to believe performance declines without supplementation, reinforcing habitual use.
A balanced strategy incorporating natural dietary NO sources, structured supplement cycling, psychological support, and regulatory oversight is essential. The General Administration of Sport of China (GASC) and National Medical Products Administration (NMPA) should strengthen supplement quality control, labeling accuracy, and athlete education. Future research should assess long-term cardiovascular effects to guide safer supplementation practices. By optimizing natural NO production and responsible use, Chinese athletes can enhance performance sustainably while minimizing health risks.