An Apple a Day Keeps the Doctor Away: Does Cider Vinegar Lower BP?

Apple cider vinegar has been touted as a treatment for hypertension, with those following this advice taking in the region of 15 mL, (around 1 tablespoon or 3 teaspoons) once per day. But is there any truth to this claim, or is it just urban legend?

What is apple cider vinegar?

Apple cider vinegar (or ACV) is made from the fermentation of apples and can be prepared at home. Production effectively relies upon apples being placed in water so the sugars in them break down through a two-stage pathway. In the first stage, the fruit sugars are subjected to glycolysis (breaking down) by yeasts, such as Saccharomyces cerevisiae, to form ethanol (alcohol). The second stage involves oxidation, during which the ethanol is converted into acetic acid (vinegar) by a species of acetobacter, such as Acetobacter aceti.

Apple cider vinegar can be sold as either filtered (clear) or unfiltered and unpasteurised (cloudy). It’s the latter version that’s said to have health benefits, due to the presence of ‘good bacteria’, sometimes referred to as the ‘mother culture’.

What are the reported benefits?

The use of apple cider vinegar for health treatments has been established for millennia. Initially believed to have been discovered by a courtier in Babylonia in 2000 BCE, Hippocrates – the founder of medicine as a science – was thought to be using vinegar to heal wounds in around 420 BCE, although this is no longer recommended (for obvious reasons). In later years, vinegar was seen as a cure for many ailments, from oedema (swelling) to stomach ache, and even croup. However, while vinegar seemed to have often been used topically (on the skin), modern advocates suggest taking it as a dilute solution in water.

What about using it for blood pressure?

The evidence that ACV can reduce blood pressure is very limited, and mainly confined to decade-old trials in rats. In 2001, Kondo and co-workers reported a reduction in blood pressure of spontaneously hypertensive rats that were fed a diet of acetic acid (the main component in vinegar), as well as a reduction in renin activity, to which was attributed the reduction in BP (renin is used in the Renin-Angiotensin-Aldosterone System (RAAS) that controls BP, among other things). Other studies have suggested that vinegar may inhibit the angiotensin-converting enzyme, ACE, in rats, but more research is needed. (Side note: this is a similar mode of action to a type of antihypertensive medication used in humans, so there is merit to this argument). However, human trials are lacking, and when they have been undertaken, they have severe limitations.

Can I use apple cider vinegar for other health issues?

While the jury’s still out on the use of apple cider vinegar to lower blood pressure, there are some medical conditions where its use may be beneficial. For example, consumption of ACV by patients with type 2 diabetes was shown to lower cholesterol and blood glucose in a 2021 meta-analysis and in a 2023 study, but both had limitations and again, further investigation is needed to draw concrete conclusions.

When it comes to weight loss, the picture is also unclear. While some studies claim that consumption of vinegar can aid weight management, others state that there is insufficient evidence.

Finally, apple cider vinegar has been suggested to aid good gut health, as with many other fermented foods. The idea is that fermented foods promote formation of a diverse gut microbiome, which then has positive consequences for overall body health. Deviation from the norm in this fragile environment has been associated with many diseases, including obesity, type 2 diabetes, hepatic steatosis (fatty liver disease), intestinal bowel diseases (IBDs) and several types of cancer. However, ACV-specific evidence is lacking, and further investigation is required.

Are there any risks to drinking apple cider vinegar?

It should be noted that vinegar is an acid, therefore ingesting it means there is a risk of damaging tooth enamel and causing throat burns (so make sure to keep it away from children). In addition, because of its acidic nature, the risk of acid reflux (heartburn) is also increased. If you do decide to consume ACV, remember to limit your intake to a maximum of 30 mL/day. It’s also a good idea to dilute it in water, use a straw, and rinse your mouth after taking it to limit enamel damage.

The take home

The evidence around the consumption of apple cider vinegar as a tool to reduce blood pressure is patchy at best, and entirely missing at worst. Its use in treating other health conditions, such as lowering cholesterol, aiding weight management, and improving gut health is also limited. While there are very few known adverse effects from taking apple cider vinegar, application onto the skin could cause burns, and consuming too large a quantity in the long term could be dangerous. ACV is, after all, a form of acid, and could disrupt your body’s pH, leading to mineral depletion and lower bone density as your body tries to regain balance. If you suffer from hypokalemia (low potassium in the blood) it may be best to avoid it. There is also a risk that it could interact with some medicines, such as diuretics for hypertension treatment and insulin.

This article is for informational purposes only and does not contain nor replace medical advice. The information in this article is not intended to diagnose, treat, cure, or prevent any disease. Talk to a qualified medical professional before making any changes to your health regimen.

FAQs

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