Does carbonated water have an effect on blood pressure control in individuals with hypertension?

Carbonated Water and Blood Pressure: Scientific Evidence

There is no scientific evidence that carbonated water lowers blood pressure in individuals with hypertension. The available guidelines do not recommend carbonated water as a strategy for blood pressure control.

Evidence on Carbonated Water and Blood Pressure

Current research on carbonated water's effect on blood pressure is limited and inconclusive:

• A 2024 systematic review found uncertainty regarding whether hypertensive patients should avoid carbonated water consumption, with no clear evidence supporting blood pressure reduction 1

• Some studies actually suggest that cold carbonated water may cause a temporary pressor (blood pressure-raising) effect, particularly in older adults 2

• A study examining sodium-rich carbonated mineral water found no significant effect on blood pressure in normotensive individuals, though the authors noted these results should be verified in hypertensive subjects who may be more salt-sensitive 3

• A 2024 randomized controlled trial found that mineral water high in bicarbonate and sodium did not significantly affect blood pressure compared to low bicarbonate/sodium water 4

Established Dietary Approaches for Blood Pressure Control

Instead of carbonated water, guidelines recommend the following evidence-based dietary approaches for blood pressure management:

1. Sodium Restriction

• Reducing sodium intake to 2.3 g/day (100 mmol/day) can lower systolic and diastolic blood pressure by 4-6 mmHg 5
• Salt reduction is particularly effective in Black individuals, older adults, and those with diabetes or chronic kidney disease 5
• Dietary salt restriction to less than 100 mEq of sodium/24-hour is recommended for all patients with resistant hypertension 5

2. DASH Diet

• A diet rich in fruits, vegetables, low-fat dairy products, and reduced saturated fat can reduce systolic and diastolic blood pressure by 11.4 and 5.5 mmHg, respectively 5
• This dietary pattern has consistently shown blood pressure-lowering effects 5

3. Weight Loss

• A 5.1 kg weight loss is associated with average reductions of 4.4 mmHg in systolic and 3.6 mmHg in diastolic blood pressure 5
• Even modest weight reduction can significantly improve blood pressure control 5

4. Alcohol Moderation

• Limiting alcohol consumption to no more than 2 drinks per day for men and 1 drink per day for women can reduce systolic and diastolic blood pressure by 3.3 and 2.0 mmHg, respectively 5
• The relationship between alcohol reduction and blood pressure decrease is dose-dependent 5

5. Physical Activity

• Regular aerobic exercise reduces resting systolic and diastolic blood pressure by 3.0/2.4 mmHg 5
• The effect is more pronounced in hypertensive individuals (6.9/4.9 mmHg) 5
• Exercise for at least 30 minutes on most days of the week is recommended 5

6. Increased Potassium Intake

• Increased potassium intake through fruits and vegetables has blood pressure-lowering effects 5
• The DASH diet provides approximately 4.7 g/day of potassium 5

Clinical Implications

When counseling patients about blood pressure management:

• Focus on established dietary interventions like sodium restriction, DASH diet, and weight loss rather than carbonated water
• Be aware that cold carbonated beverages may temporarily increase blood pressure in some individuals 2
• If patients consume carbonated mineral water, consider its sodium content, as high-sodium beverages could potentially affect blood pressure in salt-sensitive individuals
• Note that sodium bicarbonate (found in some carbonated waters) appears to have less impact on blood pressure than equivalent amounts of sodium chloride 3, 6

There is insufficient evidence to recommend carbonated water as a strategy for blood pressure reduction, and established dietary approaches should be prioritized for hypertension management.