By DeanSilverMD.com Health Team
Maybe a little, but it has not been reliably shown. Small, short trials suggest apple cider vinegar (ACV) might lower blood pressure by a few points. The best pooled analysis rated that evidence low-certainty, and a trial in people with type 2 diabetes did not show a clear difference. ACV has not been shown to replace blood pressure medicine. If you take blood pressure medicine, a diuretic, digoxin, or insulin or other glucose-lowering drugs, ask your prescriber or pharmacist before adding it. Keep taking your prescribed medicines in the meantime.
This is an independent editorial article from the DeanSilverMD.com Health Team. It is general information, not medical advice, and it does not create a doctor-patient relationship.
The short answer
- Weak signal: A 2022 analysis of four small trials estimated a few points lower systolic (top-number) pressure, but rated the certainty of that evidence low.
- Not consistent: A 2023 trial in adults with type 2 diabetes found no statistically significant blood pressure difference between the ACV group and the comparison group.
- Not a substitute: The Tufts Health & Nutrition Letter says the data are insufficient and advises not drinking ACV straight, talking to your doctor first, and continuing regular blood pressure medications.
How strong is the evidence?
Here is what each kind of research can and cannot tell you.
- Animal and lab studies: weakest. Healthline's review notes that many studies on ACV and blood pressure are older, involve animals or rodents, or have design limits. Results in animals do not reliably carry over to people.
- Small human trials and pooled analyses: limited, low certainty. A 2022 systematic review and meta-analysis (Shahinfar and colleagues, Complementary Therapies in Medicine) pooled four trials with 298 adults, followed for 7 to 12 weeks and given 15 to 30 mL of vinegar a day. The participants had conditions such as obesity, type 2 diabetes or high blood fats, and were not chosen for high blood pressure. The vinegars were not all apple cider vinegar. The dose-response model estimated about 3.25 mmHg lower systolic pressure per 30 mL a day (95% confidence interval about 1 to 5.5 mmHg). The authors rated certainty as low, and results varied widely across trials. When they applied a more cautious adjustment for the small number of studies, the pooled systolic result was no longer statistically significant. They call for larger, longer, better-designed trials. A 2023 randomized trial (Jafarirad and colleagues, Frontiers in Clinical Diabetes and Healthcare) gave adults with type 2 diabetes 30 mL of homemade ACV daily for eight weeks. It was open-label with no placebo, and 73 people completed the trial. Systolic pressure fell in both groups (about 5.7 mmHg with ACV, about 1.9 without), but the difference between groups was not statistically significant (p = 0.06), and diastolic pressure did not differ. Blood pressure was a secondary outcome. The doses above describe what researchers used, not what they recommend.
- Still unproven. None of the sources we reviewed showed that ACV lowers blood pressure enough to matter for your health, prevents heart attacks or strokes, is safe long-term alongside blood pressure medicines, or has a best dose. The Tufts Health & Nutrition Letter (published 2016, updated 2019) concluded the data were insufficient. It also noted that two tablespoons of ACV has about 20 mg of potassium, under 1% of the roughly 4,700 mg an adult needs daily.
Medication caution grid
We found no controlled studies testing ACV together with these drugs. Healthline's review says there are no controlled studies of ACV's effect on blood potassium and describes a single case report of low potassium after about a cup of diluted ACV every day for six years. The cautions below come from how these medicines affect potassium and blood sugar, and from clinical summaries. Treat them as reasons to ask, not proven interactions.
- Diuretics (water pills): Some cause potassium loss, and Healthline advises not combining certain diuretics with large amounts of vinegar. Others, such as spironolactone, can raise potassium, so which diuretic you take matters. Ask before starting.
- ACE inhibitors (such as lisinopril or ramipril): Mayo Clinic lists ACE inhibitors among medicines that can cause high potassium. We found no source establishing a specific interaction between ACV and them. Still, tell your clinician before adding ACV so they can interpret changes in your readings or lab work correctly.
- Insulin and other glucose-lowering medicines: Healthline warns that vinegar with insulin or insulin-stimulating drugs may cause dangerously low blood sugar or potassium. The 2023 trial above excluded people who inject insulin, so it cannot speak to them. Our separate look at apple cider vinegar and blood sugar covers the glucose side, though it focuses on blood sugar rather than blood pressure.
- Digoxin: Healthline lists digoxin among medicines that may interact with ACV through potassium but gives little detail. Because people taking digoxin have potassium balance closely monitored, check with your prescriber before using ACV.
Also speak with a clinician first if you have kidney disease, since the kidneys are the most common source of potassium problems, or gastroparesis, which Healthline lists as a reason to avoid ACV.
A simple home blood pressure log
If you and your clinician agree you can try ACV, a log shows whether anything changes. The American Heart Association recommends a validated, automatic upper-arm cuff monitor. It advises avoiding smoking, caffeine and exercise for 30 minutes beforehand, resting quietly for at least five minutes, and taking two readings one minute apart at the same times each day. Its printable log suggests tracking for at least 3 days and preferably 7 days before an appointment. That means two readings in the morning before medication and eating, and two at bedtime.
Copy these fields into a notebook or spreadsheet for each reading session:
- Date and time: morning or bedtime
- Reading 1 and Reading 2: top and bottom numbers, one minute apart
- Medicines taken: names and times, including any changes
- ACV use: whether you took any, how much, diluted in what, and when
- Notes: dizziness, lightheadedness, muscle cramps, stomach upset, or other changes
For reference, the AHA's categories are normal below 120/80, elevated 120 to 129 with diastolic below 80, stage 1 at 130 to 139 or 80 to 89, and stage 2 at 140/90 or higher. Only a clinician can diagnose high blood pressure or adjust treatment, and the AHA says not to stop blood pressure medicine because of home readings.
If your readings are suddenly higher than 180/120, the AHA says to wait at least one minute and test again. If they are still very high, contact your healthcare professional immediately. If you also have chest pain, shortness of breath, back pain, numbness, weakness, a change in vision or difficulty speaking, call 911.
What you can do next
- Do not stop or change medicines because of anything you read about ACV.
- Bring this article and your log to your clinician or pharmacist, along with a list of everything you take.
- If you use ACV anyway, never drink it straight, as Tufts advises. Healthline's review also lists nausea and tooth enamel erosion as known side effects.
- Look at better-studied steps. Healthline notes that lowering salt intake helps blood pressure and has been studied more thoroughly than ACV.
Sources reviewed
Sources reviewed October 3, 2026.
- Shahinfar H, et al. Dose-dependent effect of vinegar on blood pressure: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials. Complementary Therapies in Medicine, 2022. ScienceDirect
- Jafarirad S, et al. Apple cider vinegar and anthropometric indices, blood glucose and lipid profile in diabetic patients: a randomized controlled clinical trial. Frontiers in Clinical Diabetes and Healthcare, 2023. PubMed Central
- Tufts Health & Nutrition Letter, “Will apple cider vinegar really improve blood pressure?” (2016, updated 2019). Tufts
- Healthline, “Using Apple Cider Vinegar to Help Lower Blood Pressure” (updated January 13, 2025). Healthline
- Healthline, “7 Side Effects of Too Much Apple Cider Vinegar” (updated January 12, 2024). Healthline
- Mayo Clinic, High potassium (hyperkalemia): causes. Mayo Clinic
- MedlinePlus, High potassium level. MedlinePlus
- American Heart Association, Home Blood Pressure Monitoring, and My Blood Pressure Log. AHA