Blood pressure not coming down


(Muzammil) #1

Hello friends,

I am writing this for my mother who has been doing keto since feb 20 and the sugar levels have come down considerably but blood pressure has remained the same despite taking medications. Triglycerides has also gone upto 200.carb amount is within keto limits. Can anybody tell why this is happening

(Edith) #2

We usually don’t recommend having blood tests until someone has been following keto for about six months. The body has to learn how to adapt to being a fat burner and it takes time.

This is my nonprofessional guess, but I believe that once she gets fat adapted, her triglycerides will slowly start to come down over time. Keto is not a magic wand. It does heal, but healing takes time. I’m sure your mother didn’t develop high blood sugar and high blood pressure over night. It won’t get cured over night, either.

One last thought: we do have some members here who have been keto for a long time, their type 2 diabetes is in remission, but are still on their blood pressure meds. If any of them read this, maybe they can weigh in.

(A fool and his bacon are soon parted) #3

As Edie suggests, it’s not quite time to worry, yet. Give things another couple of months before assuming there’s a problem.

Also be sure to look at inflammatory markers (white blood cells, C-reactive protein, ferritin, and the like), HbA1C, HOMA-IR score, and the ratio of triglycerides to HDL. If they are improving, then you know that things are well. In particular, the triglycerides are not so much of a problem if the HDL has gone up to match. A ratio of 2.0 or less (0.9 or less in European measurements) indicates minimal cardiovascular risk.

In the meantime, make sure your mother is getting enough salt and staying hyrdated. This will help with her electrolyte balance and blood volume, and might possibly help improve her blood pressure. Recent studies have shown that we need more salt than the official dietary recommendations would suggest.

Another thing you can do might be to look carefully at what your mother is eating, and verify that her carb intake is really as low as you think. There may be hidden sources of carbohydrate that have been overlooked. This is not as much of a concern if she is eating whole real foods, but if there are any processed foods in her meals, they could be a problem. It’s something to double-check, in any case.

Lastly, if you can afford to get a home ketone meter, you could double-check your mother’s ketone levels and make sure that she is indeed getting into ketosis.

Let us know how things go.

(Marianne) #4

I have been on clean keto for two years and carnivore for almost a year and a half. My blood pressure is still high and I am on two medications for it. It never got better on keto. I chalk it up to genetics. I’m glad there are medications that control it.


I am not a doctor, however, I have friends that have had the same experience as your mother. They eliminated the 35% cream in their coffees and this resolved the rise in Triglycerides.


Lowering any fat will lower the trigs, but that doesn’t fix anything either as they’re not a problem to begin with, even if you ate crazy levels taking the test fasted takes care of that.


Is she physically active? Properly hydrated? (most people aren’t). I can notice an extreme difference in my BP after a couple of days of intentionally hydrating correctly vs when I don’t. Also on the carbs, if she’s not tracking what she’s eating, than she doesn’t know. People are beyond terrible at that, they’ve literally done studies on it. Many people also screw up net carbs huge and are eating way more than they think they are, which combined with high fat doesn’t end well.

(Bob M) #8

I think it’s the other way around: trigs lower with fat content. See this:


4.5 days fasting, followed by drinking cups of cream for 3 days.

Another example:

She ate very high fat carnivore.

(cerastez) #9

When I first started on keto, nothing happened to my blood pressure. But when I got to the point where I had lost 25 pounds my blood pressure suddenly dropped.

Your mother should watch out for this. If she is like me she will get all of the symptoms of taking too much blood pressure medicine. I was so dizzy that I could barely stand. Shortly after the doctor took me off all blood pressure medicine.


No idea re the BP. It’s too early for any answers on lipids.

The ideal triglyceride to HDL ratio is 1 or 1.5. All the other numbers like total chol and LDLs are meaningless because they change hourly. Give it some time – 2 months minimum or more esp for women.

(Jane) #11

My husband has been on keto over 4 years and never on meds prior to this year. In Feb at his annual physical his blood pressure was high so he was put on meds.

Last week his blood pressure shot up even taking an extra BP pill and he started having chest pains so I took him to the emergency room. They admitted him and after a full day of tests they didn’t find anything and released him.

He had a heart catheter test this morning and they found blockages in two of his arteries and installed stents. The doc said his blood flow was improved. The before and after pics were eye openers. I am grateful they finally found the cause and were able to fix it without major surgery. He was even awake during the procedure. I have to travel to Houston on Sunday and will be there 2 weeks on business so I was very worried about leaving him alone without knowing the cause. Now I can go and feel ok about it.

So just to add to the others that keto is great for blood sugar control, reducing inflammation, etc. but it doesn’t fix everything!


Isn’t this concerning? If he was keto for four years, it seems easy to wonder whether his diet somehow contributed. I wonder if a high fat diet actually is a risk factor for atherosclerosis among some of us.

(Robin) #13

It’s just as likely that he is still alive thanks to keto. He may have been healthier thanks to his diet and thus fared better.

It’s also possible it is totally genetic or not connected in any way to his diet.

(Jane) #14

We don’t particularly eat a “high fat diet” - we just switched form seed oils to saturated fats and eat about the same amount of fat as before.

I agree with @robintemplin that keto probably helped, not hurt. He has no other risk factors so I am chalking it up to years of a SAD diet which he abused since he never gained weight. And genetics.

(Bob M) #15

It can be quite a challenge to determine why some people have this and others don’t. Why did I eat a terrible diet for a while, yet score zero on a CAC scan? I honestly have no idea (particularly because my Lp(a) is through the roof).

(Kirk Wolak) #16

I feel you. I have to eat carnivore (Meat, Salt, Water) to keep my BP under control.
Takes about 3-4 weeks like that to bring it back down to normal.

It’s amazing how many foods raise my BP. In fact, when I am clean, I will fast for a couple of days. Take my BP and then eat a “test” food. And if my BP moves up within 30-60 minutes. I know that food is inflammation for me.

And it’s the inflammation related to BP being high that concerns me. I don’t notice High BP, but I do feel it when it goes low!


What is the blood pressure number?