Creatine supplements, typically used to boost athletic performance, may affect blood pressure in certain people. Even so, study results are mixed, with some suggesting that creatine can help lower blood pressure, while others have found that it has no effect or may even raise blood pressure.

How Creatine and Blood Pressure Are Linked

Although studies suggest that creatine supplements may affect blood pressure, the findings are often contradictory. In some groups, creatinine may have a beneficial effect, lowering systolic (upper) and/or diastolic (lower) blood pressure. In others, it may have no effect or cause blood pressure to rise.

Either way, the effect of creatine on blood pressure is generally minimal but may still warrant attention in some people.

Studies Showing Potential Benefits

Creatine supplements may have a positive effect on blood pressure due to their antioxidant effects. By reducing oxidative stress, the size, flexibility, and reactivity of blood vessels may increase, modestly lowering blood pressure.

The antioxidative effects may reduce arterial stiffness associated with atherosclerosis (hardening of the arteries), a leading cause of hypertension in adults.

Among the findings:

• Healthy, young males: A 2014 study from Brazil reported that physically active, young men (median age 28) experienced a slight drop in blood pressure after taking 20 grams of creatine for seven days. This effect was attributed to increased vascular density and reactivity.
• Older adults: A 2024 study reported that older males (median age 71) given a daily, 20-gram dose of creatine experienced a slight decrease in systolic blood pressure, whereas those given a sham drug showed no change. Even so, the drop was considered statistically irrelevant.

Studies Showing No Effect

The current body of research suggests that creatine supplements are generally safe in healthy adults, with little, if any, impact on blood pressure.

Among the available research:

• Bodybuilders: A 2017 study found that the long-term use of creatine supplements in bodybuilders (up to 15 grams daily) increased the resting heart rate by around 14% compared to those who didn’t use supplements, but had no impact on blood pressure.
• Athletes: A 2018 study found that creatine supplements had no effect on blood pressure among 45 young adults who engaged in high-intensity resistance training. There was also no evidence of decreased vascular stiffness or increased vascular reactivity.

Studies Showing Potential Harm

In some people, creatine supplements might end up increasing blood pressure, particularly those with pre-existing hypertension (high blood pressure) or kidney disease.

This is because high levels of ATP can overstimulate the sympathetic nervous system, causing the narrowing of blood vessels (vasoconstriction) and an associated increase in blood pressure.

Research shows:

• Adult males: A seven-year study involving 3,135 adults (median age 49) found that persistently high creatine levels increased the risk of hypertension by 26% in males, but did not increase the risk in females.
• People with hypertension: A 2019 review of studies reported that persistently high creatine levels increase the risk of hypertension and are also linked to a four-fold increased risk of treatment failure for people on antihypertensive therapy.

What Is Creatine Used For?

Creatine is a substance composed of amino acids that the body converts into the energy source adenosine triphosphate (ATP). Among ATP’s functions, it fuels muscle contraction and can also act on the sympathetic nervous system, a part of the nervous system that helps regulate blood pressure.

About half the creatine in your body is produced by the liver, kidneys, and pancreas, while the other half is derived from foods you eat, particularly red meat, shellfish, and dairy.

Creatine supplements are a synthetic form of creatine produced in a lab. They provide a concentrated dose far above the 1 gram your body naturally produces each day.

When combined with resistance (strength) training, creatine supplements may help:

What Creatine Dosage Is Safe?

Creatine monohydrate, the most common creatine supplement sold in the U.S., is generally regarded as safe for healthy adults by the U.S. Food and Drug Administration (FDA).

There are no established guidelines for the appropriate use of creatine supplements, but daily doses between 3 and 5 grams are generally recommended.

Loading up on a higher dose has not been shown to be any more effective over the long term than taking a standard 3- to 5-gram dose. Doing so simply saturates your muscles with creatine faster, but can also lead to side effects like bloating, stomach upset, weight gain, and diarrhea.

Who Shouldn’t Use Creatine Supplements?

In certain groups, creatine should be avoided or used with extreme caution, including people with:

• Kidney disease: Creatine can increase blood creatinine levels, putting strain on the kidneys. Taken at very high doses, it can lead even to kidney failure in those with underlying chronic kidney disease.
• Hypertension: High creatine use can make existing hypertension harder to treat. It can also put strain on the kidneys, which contributes to hypertension.
• Bipolar disorder: In addition to muscles, some creatine is absorbed by the brain. While this effect may be beneficial in some people, improving attention and memory, it can trigger a manic episode in people with bipolar depression.

Due to the lack of safety research, creatine should not be used in children or adolescents under 18 or in people who are pregnant or breastfeeding.