Effect of ketogenic diet on blood pressure: A GRADE-Assessed systematic review and meta-analysis of randomized controlled trials.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of 23 randomized controlled trials
PubMed 38310076 · doi:10.1016/j.numecd.2023.12.004
What was done
The authors conducted a systematic review and meta-analysis across four databases (PubMed/Medline, SCOPUS, Cochrane Library, and Google Scholar) from inception to November 2022 to evaluate the impact of ketogenic diets on systolic and diastolic blood pressure (SBP and DBP). Only randomized controlled trials (RCTs) were included. The analysis pooled 23 RCTs encompassing 1,664 participants, and included subgroup analyses as well as a non-linear dose-response analysis evaluating the percentage of caloric intake from fat.
What was found
Ketogenic diets did not produce statistically significant reductions in blood pressure compared to control conditions. The weighted mean difference (WMD) was -0.87 mmHg (95% CI: -2.05 to 0.31) for SBP and -0.11 mmHg (95% CI: -1.14 to 0.93) for DBP. Subgroup analyses did not identify meaningful modifiers, and non-linear dose-response analysis detected no association between the percentage of fat calories in the diet and blood pressure changes.
Why it matters
Despite popular interest in ketogenic diets for metabolic and cardiovascular health, pooled trial evidence demonstrates no clinically or statistically meaningful effect on blood pressure regulation.
Limits
The abstract does not report baseline hypertensive status, participant adherence, background sodium intake, trial durations, or comparator diet compositions. The specific GRADE certainty ratings for each outcome are also omitted from the abstract text.
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