High blood pressure, also called hypertension, is a significant health problem that can put you at risk of developing cardiovascular disease, stroke, and other conditions if not treated and controlled. There are medications to help lower blood pressure and support heart health, but evidence indicates that following a ketogenic diet may also offer significant benefits.

This regimen stipulates a very low-carbohydrate, high protein, and healthy fat intake, putting you in a fat-burning state called ketosis. Does ketosis affect blood pressure?

Evidence indicates that the keto diet may decrease blood pressure and support other aspects of metabolic health like balancing insulin, blood sugar levels, and cholesterol. In this article, we explore the reasons for this effect, the potential benefits of the keto diet for blood pressure, and provide practical tips for a successful, healthy keto diet

Key Takeaways

  • Is the keto diet good for high cholesterol and high blood pressure? Some evidence indicates that following a low-carbohydrate regimen may support heart health, lower cholesterol, and other metabolic parameters, and decrease blood pressure.
  • The keto diet may help decrease blood pressure by lowering insulin resistance, decreasing inflammation, promoting weight loss, and improving blood vessel function.
  • Individuals with kidney or liver conditions, eating disorders, or hypoglycemia should avoid the keto diet, as should people who are pregnant, breastfeeding, or taking blood pressure medication.
  • To follow a successful keto diet for lowering blood pressure, make sure you consult with a physician and dietician, make quality food choices, and stay hydrated.

What is High Blood Pressure?

Hypertension occurs when the force of the blood flowing against the walls of the arteries is too high, putting pressure on the heart as it tries to pump blood around the body. Over time this can damage the arteries and increase your risk of heart disease, stroke, kidney impairment, vision loss, sexual dysfunction, and other conditions if not treated and controlled.

High blood pressure is called the ‘silent killer’ as it often has no accompanying symptoms except potentially fatigue or headaches. According to cardiologist Marc Eisenberg, MD, about 1 in 5 people are not even aware that they have the condition [1].

Blood pressure measures indicate both systolic pressure, or the force the heart exerts when it pumps blood to the body, and diastolic pressure, which is the force against your blood vessels when the heart is at rest.

Some evidence suggests that a low carbohydrate regimen may help lower both systolic and diastolic levels. Why does blood pressure drop on the keto diet? In the next section, we explore the mechanisms in detail.

How the Keto Diet Can Help Lower Blood Pressure

keto diet for blood pressure management Explore the potential benefits of the keto diet for blood pressure management

High blood pressure may result from several factors, some out of your control like age and genetics, and others that can be managed like poor diet, obesity, smoking, excess alcohol, and a sedentary lifestyle.

While the keto diet can’t help you quit bad habits, following this regimen supports several parameters of health that may help lower blood pressure, including:

Reducing Insulin Resistance

Following a high carbohydrate diet consistently can lead to spikes in insulin levels, and the high levels may cause a condition called insulin resistance. In this state, your cells become resistant to the insulin circulating in your bloodstream, putting you at risk for metabolic issues and high blood pressure.

While study results vary, some evidence [2] indicates that switching to a low-carb, ketogenic diet may help lower insulin levels and decrease insulin resistance. This has an impact on blood pressure by lowering both total blood volume and decreasing water retention.

In addition, lowering insulin levels may help rid the body of excess sodium to decrease blood pressure. The improvement in insulin levels may also help improve other measures of metabolic health that impact blood pressure, like lowering cholesterol, triglycerides, and blood sugar.

Supporting Weight Loss

Obesity is a major risk factor for hypertension, as it could lead to spikes in insulin levels and damage to the heart and arteries. Following a low carbohydrate diet causes your body to release ketone bodies and enter a state called ketosis, which leads your body to burn natural belly fat stores as energy instead of glucose.

Losing weight can help decrease blood pressure, as evidence indicates. A study in the International Journal of Environmental Research and Public Health by David J Unwin, et al concluded that a long-term low-carbohydrate diet reduced weight and blood pressure and improved lipid profiles in patients with type II diabetes [3].

Improving Blood Vessel Function

The increase in ketone bodies in your system as a result of following the keto diet may help repair damage to the blood vessels and support the function of cardiac endothelial cells. This leads to a stronger network of blood vessels and helps strengthen the arterial walls to support lower blood pressure levels.

Lowering Inflammation

A diet high in carbohydrates over a long period can lead to chronic inflammation, as indicated by a 20-year longitudinal study published in Nutrients [4]. High levels of inflammatory cytokines in the bloodstream can cause the blood vessels to become constricted, potentially leading to high blood pressure.

Following the keto diet helps to lower inflammation in the body, widening the vessels to help improve blood pressure.

Potential Benefits of a Keto Diet for Blood Pressure

Having examined the mechanisms through which the keto diet may lower blood pressure, let’s summarize the benefits of this regimen for managing hypertension. These are the primary potential benefits of following the keto diet for lowering blood pressure:

Improving Blood Sugar Control:

By supporting insulin levels and lowering insulin resistance, the keto diet promotes healthy blood sugar levels, which support arterial and heart health and may help lower blood pressure.

“Can a keto diet raise your blood pressure?” If your blood sugar levels drop too low on the keto diet, in some cases it may lead to hypertension.

Reducing the Risk of Heart Disease:

By supporting endothelial cell and blood vessel function and promoting weight loss, following the keto diet may help support heart health, reduce the risk of cardiovascular disease, and potentially decrease blood pressure.

Increasing Energy Levels:

The keto diet is known for its ability to boost daily energy levels, which could lead to increased physical activity. The additional exercise helps promote weight loss and support heart health, both of which may help lower blood pressure.

Potential Risks and Considerations

The keto diet is not for everyone, and some medical conditions may preclude following this regimen, which is why it’s important to consult with a healthcare practitioner before starting. Individuals with kidney or liver disease, eating disorders, or who are pregnant or breastfeeding should avoid this diet in particular.

In addition, on the keto diet, low blood sugar may occur in some cases. For this reason, individuals with hypoglycemia should also exercise caution before deciding to radically cut their carbs.

Combining keto and high blood pressure medication is also not advisable, and you should check with a physician if you take any medication to ensure that the diet is safe for you.

In addition, when you follow the keto diet, it’s important to ensure that you include adequate fruits, vegetables, and other nutrient-rich foods, or over time your health could suffer and the regimen may negatively impact heart health. Although not common, there is a potential link between following the keto diet and heart arrhythmia.

Tips for a Successful Keto Diet for Blood Pressure

You may be wondering, how long does it take to lower blood pressure with keto? While for some the results may be rapid, for others it may take time for the body to adapt.

A 2023 study published in the Journal of Translational Medicine by Luigi Barrea, et al found that a very low-calorie ketogenic diet helped promote weight loss and blood pressure in women with obesity in 45 days [5]. You can help enhance your results by following some of these tips to optimize your keto diet:

  • Consult With Healthcare Professionals – Before you decide to embark on the keto diet, check with a physician to ensure that it’s suitable for you. In addition, to plan your meals successfully and optimize health benefits like lowering blood pressure, consider meeting with a dietician to discuss food choices.
  • Start Slowly – Any new dietary regimen takes adjustment, and with a radical change like cutting out most of your carbohydrates it’s important to proceed gradually for success. Rather than jumping to 30-50g of carbs daily quickly, begin with a higher amount like 150, then lower the count each week or two so your body can adjust.
  • Drink Plenty of Water – Keeping sufficiently hydrated daily helps support overall health, and it may also keep you feeling full so you are less likely to be hungry or have cravings in between meals.
  • Examine Labels Carefully – There are often hidden carbohydrates and sugars in foods that you may not be aware of, so it’s important to read labels carefully to avoid going over your daily carbohydrate limit.
  • Make Smart Food Choices – Following the keto diet healthily involves more than just cutting down your carbohydrates. Because you are low in a whole food group, it’s particularly important to ensure that how many of the net carbs you do take in are healthy, plant-based sources, and you include plenty of nutrient-rich fruits and vegetables.

In addition, make sure the fats you are consuming are healthy sources like olive oil, nuts, and avocado, and include plenty of rich protein like fish, lean meat, eggs, and tofu.

Conclusion

Following a low carbohydrate, ketogenic diet helps promote fat and weight loss, and it may also offer other health benefits like supporting metabolic health, boosting energy, and decreasing the risk of heart disease, all of which could contribute to lowering blood pressure levels.

If you are considering following this diet, check with a physician first to ensure that it’s suitable for you, and make sure you include plenty of nutrient-rich fruits and vegetables, healthy fats, and quality protein sources to ensure that you are meeting nutritional requirements.