Which diet is better for lowering high blood pressure: keto or Mediterranean?

Both diets significantly reduced blood pressure in the study, but the Mediterranean diet showed better nighttime blood pressure control. The keto diet led to greater short-term weight loss.

Is the ketogenic diet safe for people with high blood pressure?

In this short-term study, the ketogenic diet was safe and did not cause inflammation or kidney issues. However, long-term use should be monitored by a healthcare provider due to sodium and fat content.

How much can diet reduce blood pressure?

Weight loss of just 5 kg can reduce systolic blood pressure by about 4.4 mmHg. Both diets in the study lowered systolic BP by about 9 mmHg over three months.

What is nocturnal dipping and why is it important?

Nocturnal dipping is the normal drop in blood pressure during sleep. Its presence indicates healthy cardiovascular function. The Mediterranean diet group had more frequent dipping episodes, suggesting better nighttime blood pressure regulation.

Mediterranean Or Keto? Study Finds Both Diets Improve Blood Pressure

mediterranean vs keto for high blood pressure

A new clinical investigation published in Nutrients has confirmed that both the Mediterranean diet and a low-calorie ketogenic diet (KD) can significantly reduce blood pressure and support weight loss in individuals with elevated cardiovascular risk.

The findings suggest that dietary modification remains a powerful, non-pharmacological tool in the management of early-stage hypertension and obesity-related cardiovascular disorders.

The study, titled “The Keto–Salt Pilot Study,” directly compared the metabolic and cardiovascular effects of two popular diets in a group of overweight or obese patients diagnosed with high-normal blood pressure or grade 1 hypertension.

Key Study Highlights

Both diets led to significant reductions in systolic and diastolic blood pressure.
Participants on the ketogenic diet lost more weight on average, but both groups showed improved body composition.
The Mediterranean diet group demonstrated more frequent nocturnal blood pressure dipping, an important cardiovascular health marker.
No adverse kidney or inflammatory responses were observed in either group.
Both diets were well-tolerated and deemed safe for short-term use under clinical supervision.

Contents

Background: Why Diet Plays a Central Role in Blood Pressure Control

According to WHO data, more than 2.5 billion people worldwide are overweight, and about 1 billion live with obesity.

This global health burden is strongly tied to elevated risks of:

Hypertension
Type 2 diabetes
Dyslipidemia
Cardiovascular disease (CVD)

Weight loss has been clinically shown to lower blood pressure, with evidence suggesting that a 5 kg weight reduction can lower systolic pressure by 4.4 mmHg and diastolic pressure by 3.6 mmHg.

The goal of the current study was to evaluate which dietary protocol—Mediterranean or ketogenic—offers better outcomes for hypertensive patients.

Read also: Diet For High Blood Pressure

Study Design and Population

The prospective pilot trial included 26 non-diabetic adults, each with:

A BMI ≥ 27 kg/m²
Abdominal obesity (central fat accumulation)
High-normal BP (≥130/85 mmHg) or grade 1 hypertension (140–160/90–100 mmHg)

Participants were randomized into two groups:

15 subjects followed a low-calorie, high-protein ketogenic diet
11 subjects adopted a Mediterranean diet focused on low sodium and high potassium intake

The intervention lasted three months and was monitored through:

Ambulatory blood pressure monitoring (ABPM)
Bioelectrical impedance analysis (BIA)
Standard bloodwork and safety labs

Results: Blood Pressure and Body Composition Improvements in Both Groups

Both diet groups experienced statistically significant reductions in weight and blood pressure. Here’s how the changes compared:

Outcome	Ketogenic Diet Group	Mediterranean Diet Group
Baseline weight	98.6 kg	93.8 kg
Final weight	87.3 kg	86.0 kg
Mean systolic BP drop	9 mmHg	9 mmHg
Mean diastolic BP drop	~5.3 mmHg	~5.3 mmHg
Nocturnal BP dipping	Less frequent	More frequent

Interpretation: Metabolic Gains Are Comparable, Cardiovascular Markers Differ

While both diets achieved comparable blood pressure reductions, the Mediterranean diet showed advantages in nighttime BP modulation, a subtle but clinically meaningful marker linked to lower cardiovascular mortality.

Additionally, the ketogenic diet achieved more aggressive short-term weight loss, likely due to carbohydrate restriction and metabolic adaptation.

Researchers emphasize that no inflammatory markers or signs of renal stress were found in either group, underscoring the short-term safety of both interventions under medical supervision.

Clinical Takeaway: Personalized Nutrition Still Reigns

According to the study authors, both diets are:

Effective in reducing hypertension markers
Safe when properly guided by healthcare professionals
Capable of improving metabolic profiles and body composition

However, long-term adherence, individual tolerance, and underlying health risks must be considered.

The authors call for larger-scale, long-term studies to confirm these outcomes and define diet-specific guidelines for hypertension management.

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