Creatine is a compound naturally produced in the body, primarily by the liver, kidneys, and pancreas, and is stored mostly in skeletal muscles. It functions as a rapidly available energy source for high-intensity, short-duration activities, making it a popular performance-enhancing supplement. Hypertension, or high blood pressure, is a common condition where the force of blood against the artery walls is consistently too high. Individuals managing this condition often question the safety of supplements like creatine due to concerns about fluid balance and cardiovascular strain. This article investigates the scientific evidence regarding creatine supplementation for people managing high blood pressure.
The Current Research on Creatine and Blood Pressure
The scientific consensus suggests that for most healthy adults, standard creatine monohydrate supplementation does not significantly alter resting blood pressure. Multiple studies involving athletes, bodybuilders, and physically active young adults have generally found no adverse effects on systolic or diastolic blood pressure measurements. Even with long-term use and doses up to 15 grams daily, creatine has frequently been shown to have a neutral impact on blood pressure in healthy populations. Research findings, however, are not entirely uniform, as some studies report either small increases or slight reductions in blood pressure, suggesting a minimal overall effect. The primary concern shifts when considering individuals who already have hypertension or are undergoing treatment for it.
Addressing the Water Retention Myth
A common belief that creatine raises blood pressure stems from the misconception that it causes excessive fluid retention in a way that impacts overall blood volume. Creatine is an osmotically active substance, meaning it draws water into areas where it is highly concentrated. This mechanism does lead to water retention, but it is primarily intracellular, pulling fluid inside the muscle cells. This internal hydration is beneficial, contributing to cellular swelling that acts as a signal for muscle protein synthesis and growth. Conversely, extracellular fluid is the water found outside the cells, and an increase in this fluid is what typically contributes to systemic blood volume and pressure changes. Studies have consistently shown that creatine does not significantly increase extracellular fluid volume.
Creatine Use and Kidney Health Concerns
The relationship between creatine and kidney health is particularly relevant for individuals with hypertension, as high blood pressure can compromise kidney function over time. Creatine is naturally metabolized into a waste product called creatinine, which the kidneys filter out of the bloodstream and excrete through urine. When a person takes a creatine supplement, the resulting increase in muscle creatine stores leads to a harmless elevation of creatinine in the blood. This elevated creatinine level can sometimes be misinterpreted on a blood test as a sign of kidney damage, even when the kidneys are functioning perfectly well. While extensive research confirms that creatine is safe for healthy kidneys at recommended dosages, this safety does not extend to those with pre-existing or compromised kidney function, underscoring the need for careful medical oversight.
Guidelines for Use When Managing Hypertension
Anyone managing hypertension should consult with a healthcare provider before beginning any new supplement, including creatine. A physician can assess the individual’s overall cardiovascular and kidney health status before introducing an ergogenic aid. This medical clearance is necessary, particularly if there is any indication of compromised kidney function or if blood pressure is not well-controlled. If cleared for use, avoid the high-dose loading phase of 20 grams per day often suggested for athletes. Instead, a lower maintenance dose of 3 to 5 grams daily is preferred, and regular monitoring of blood pressure and maintaining excellent hydration are important steps.