Lowering Blood Pressure with the Keto Diet: A How-To Guide

High blood pressure, or hypertension, is a prevalent health condition that affects a significant portion of the global population. It is a leading risk factor for cardiovascular diseases, such as heart attacks and strokes. While medication is often prescribed to manage hypertension, lifestyle modifications, including dietary changes, can also play a crucial role in lowering and controlling blood pressure levels.

In this comprehensive guide, we delve into the potential benefits of the ketogenic diet in reducing blood pressure and provide practical tips on how to adopt this dietary approach effectively.

The ketogenic diet, commonly known as the keto diet, is a low-carbohydrate, high-fat eating plan that has gained popularity for its positive effects on weight loss, metabolic health, and overall well-being.

What is Blood Pressure?

Blood pressure refers to the force exerted by the blood against the walls of the arteries as the heart pumps it throughout the body. It is measured in millimeters of mercury (mmHg) and recorded as two numbers: systolic pressure over diastolic pressure. The systolic pressure represents the force when the heart contracts, while the diastolic pressure represents the force when the heart is at rest.

Normal blood pressure is generally considered to be around 120/80 mmHg. However, values above 130/80 mmHg are now classified as hypertension, according to the latest guidelines from the American Heart Association. Persistent high blood pressure can damage the arteries and strain the heart, increasing the risk of cardiovascular complications.

While a ketogenic diet is not for everyone, it can be a powerful tool for some. It's important to remember that any diet is only as good as its adherence and suitability to the individual's unique body and lifestyle needs.

Dr. Mark Hyman

The Keto Diet and Blood Pressure

The ketogenic diet, or keto diet for short, is a low-carbohydrate, high-fat diet that has gained popularity for its potential health benefits. Originally developed to manage epilepsy, the keto diet has shown promise in various areas, including weight loss, metabolic health, and even blood pressure regulation.

The primary goal of the keto diet is to shift the body's metabolism from relying on carbohydrates for energy to using fats as the main fuel source. By drastically reducing carbohydrate intake and increasing the consumption of healthy fats, the body enters a state called ketosis. In this metabolic state, the liver produces ketones from fats, which are then used by the body and brain as an alternative energy source.

Several mechanisms are believed to contribute to the blood pressure-lowering effects of the keto diet:

Weight Loss and Reduced Insulin Resistance

Obesity and insulin resistance are two significant risk factors for hypertension. The keto diet can help address both of these factors. By promoting weight loss, the diet can lead to a reduction in blood pressure levels. Additionally, low-carbohydrate diets have been shown to improve insulin sensitivity, leading to better blood sugar control and potentially lowering blood pressure.

Decreased Sodium Retention

High sodium intake is often associated with increased blood pressure levels. The keto diet tends to be naturally low in processed foods, which are often high in sodium. By focusing on whole, unprocessed foods, the diet naturally restricts sodium intake, potentially contributing to lower blood pressure readings.

Anti-Inflammatory Effects

Inflammation within the blood vessels can contribute to the development and progression of hypertension. The keto diet has been found to have anti-inflammatory effects in some studies. By reducing inflammation, the diet may help improve blood vessel function and lower blood pressure.

Enhanced Nutrient Intake

The keto diet emphasizes nutrient-dense foods such as avocados, nuts, seeds, fish, and leafy green vegetables. These foods are rich in minerals such as potassium and magnesium, which are known to play a role in blood pressure regulation. By incorporating these nutrient-rich foods, the keto diet may support optimal blood pressure levels.

Practical Tips for Implementing the Keto Diet

Before starting any diet, it is essential to consult with a healthcare professional, particularly if you have underlying health conditions or take medication. Here are some practical tips to help you implement the keto diet for the purpose of lowering blood pressure:

  1. Educate Yourself: Learn about the principles and guidelines of the keto diet to ensure you understand how it works and what foods are allowed or restricted. This will help you make informed choices and stay committed to the diet.
  2. Consult a Healthcare Professional: Before making any significant dietary changes, it's crucial to seek guidance from a healthcare professional, such as a registered dietitian or doctor. They can evaluate your individual health needs, provide personalized recommendations, and monitor your progress.
  3. Gradual Transition: Instead of abruptly switching to a strict keto diet, consider gradually reducing your carbohydrate intake over a period of time. This can help minimize potential side effects such as the "keto flu" and make the transition more manageable.
  4. Focus on Healthy Fats: The keto diet emphasizes consuming healthy fats, such as avocados, nuts, seeds, olive oil, and coconut oil. These fats provide essential nutrients and promote satiety. Be mindful of portion sizes to maintain an appropriate calorie intake.
  5. Moderate Protein Intake: While the keto diet is often associated with high fat consumption, it is also important to moderate your protein intake. Opt for lean sources of protein, including poultry, fish, and tofu. Excessive protein intake can potentially interfere with ketosis and affect blood pressure.
  6. Choose Low-Carb Vegetables: Incorporate non-starchy vegetables into your meals to provide fiber, vitamins, and minerals while keeping carbohydrate intake low. Examples include leafy greens, broccoli, cauliflower, zucchini, and bell peppers.
  7. Stay Hydrated: Proper hydration is vital for overall health, including blood pressure regulation. Ensure you drink an adequate amount of water throughout the day. Avoid sugary beverages and excessive caffeine, as they can negatively impact blood pressure.
  8. Monitor Sodium Intake: While the keto diet naturally restricts processed foods, it's still essential to be mindful of sodium intake. Excessive sodium can contribute to fluid retention and increase blood pressure. Opt for whole, unprocessed foods and season meals with herbs, spices, and natural flavorings instead of salt.
  9. Track Your Progress: Keep a journal or use a mobile app to track your food intake, blood pressure readings, and any symptoms or changes you experience. This can help you identify patterns, make adjustments, and monitor the effectiveness of the diet on your blood pressure levels.
  10. Lifestyle Factors: Remember that diet alone is not the sole solution for managing blood pressure. Incorporating regular physical activity, stress management techniques, and sufficient sleep into your lifestyle can further enhance the positive effects of the keto diet on blood pressure.


Individuals with high blood pressure may find benefit from the ketogenic diet. This diet can have a beneficial effect on blood pressure since it reduces carbohydrate consumption while increasing healthy fats.

This results in weight loss, improved insulin sensitivity, lower salt retention, anti-inflammatory effects, and increased nutritional intake. However, the ketogenic diet should be approached with caution, and expert medical advice should be sought before beginning. It is important to check blood pressure on a regular basis and make any required changes to diet and lifestyle.

Despite its potential, the ketogenic diet is not a panacea, and individual results may vary. In addition to focusing on food modifications, it is important to also address lifestyle aspects including regular physical activity, stress management, and adequate sleep. A healthy diet, regular exercise, stress reduction, and professional medical attention all play a role in keeping blood pressure in check. Individuals can take preventative measures toward obtaining optimal blood pressure levels and improving their cardiovascular health by embracing the concepts of the keto diet together with these lifestyle improvements.

Aaron Bernstein, MD, MPH

Aaron Bernstein is the Interim Director of The Center for Climate, Health, and the Global Environment, a pediatrician at Boston Children’s Hospital, and an Assistant Professor of Pediatrics.

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