"Does creatine increase blood pressure?" and its variants draw about 5,300 searches a month. The question usually comes from one of two people: someone who has read that creatine "retains water" and assumes the extra fluid must raise pressure, or someone who already has high blood pressure and wants to know whether creatine is safe for them. The measured record answers the first reasonably well. It does not answer the second at all. This page lists every controlled study MuscleLedger found that measured blood pressure, the trial that has never been run, and what the adverse-event reports contain. It reports evidence; it does not advise anyone whether to take creatine (how we work).
The short answer: in people whose blood pressure was normal, creatine has not raised it in any controlled study, at doses up to 20 g a day and durations from one dose to two years. In people who already have high blood pressure, nobody has tested it.
Every controlled study that measured blood pressure
| Study | Who | Creatine given | Length | Blood-pressure result |
|---|---|---|---|---|
| Mihic et al. 2000 (PMID 10694109) | 15 men, 15 women, healthy | 20 g/day vs placebo, double-blind | 5 days | No effect on systolic, diastolic or mean pressure |
| Weiss and Powers 2006 (PMID 17119520) | 24 trained men, exercising in a warm room | Loading vs placebo | 5 days | Pressure recorded every 10 min during exercise; the abstract reports no blood-pressure finding |
| Galvan et al. 2016 (PMID 27034623) | 13, then 48 active adults | Creatine nitrate 1.5–3 g, monohydrate 3–5 g, placebo | Single dose (hourly checks for 5 h), then 28 days | No harmful or consistent changes in safety markers, which included pressure |
| Dalton et al. 2017 (PMID 29244743) | 28 men and women | Creatine nitrate 3 g or 6 g vs placebo, crossover | 6 days each | No differences in blood-pressure and heart-rate responses to a posture change |
| Aron et al. 2024 (PMID 39047868) | Men aged 55–80 | 20 g/day vs placebo vs no treatment | 7 days | Right-arm systolic 144.0 → 136.1 mmHg in the creatine group, p = 0.08 (not significant); no change in the others |
| Clarke et al. 2024 (PMID 39796490) | 12 healthy, sedentary older adults | 20 g/day for 5 days, then 5 g/day, crossover | 4 weeks | Artery dilation improved; no significant change in the other outcomes, which included pulse-wave analysis |
| Two-year trial in postmenopausal women (summarised on creatine and medical conditions) | 112 completers | Creatine vs placebo, run for bone outcomes | 2 years | No between-group difference in systolic or diastolic pressure |
Two of the seven used creatine nitrate, a different salt, at lower creatine doses than a typical loading phase; they are included because they measured pressure, not because they test the monohydrate most people buy.
Three things limit this table. The studies are small — the largest blinded short-term one has 48 people. Most measured pressure as a safety check rather than as the main question. And in every one, participants began with normal or high-normal pressure.
The one trial that hints at a fall
The 2024 trial in older men is the only one to report a pressure change in the creatine group, and it pointed down: right-arm systolic pressure went from 144.0 to 136.1 mmHg, a drop of about 8 mmHg, with p = 0.08. Its stated main finding was a lower cardio-ankle vascular index, a measure of arterial stiffness (8.7 to 8.2, p = 0.03). Two cautions belong beside it. The groups were not balanced: the placebo group averaged 71.1 years against 61.4 in the creatine group. And one author discloses advisory-board membership at a creatine manufacturer and paid expert-witness work on creatine (Aron et al., Clin Nutr ESPEN 2024; registered as NCT05329480). A non-significant fall in one week does not establish that creatine lowers blood pressure.
The trial that has never been run
The people with the most at stake in this question — those with diagnosed hypertension — have not been enrolled.
- The Cochrane review. A 2011 Cochrane systematic review searched for randomised trials of creatine, creatine phosphate or cyclocreatine in adults with essential hypertension or heart disease. It found 11 trials in 1,474 patients with heart failure, heart attack or ischaemic heart disease, and states: "No trial in patients with hypertension was identified" (Horjus et al., Cochrane Database Syst Rev 2011, PMID 22071819). Several of the heart trials used injected creatine phosphate, a drug rather than a supplement.
- The registry. MuscleLedger searched ClinicalTrials.gov on 2026-10-15 with creatine as the intervention and hypertension as the condition. It returned two records, neither of which tests creatine (a statin in pulmonary hypertension, and a clinical decision-support tool). As a check that the search works, the same intervention with "blood pressure" as an outcome returned real creatine trials, including the 2024 older-men study above.
- The 2025 expert review. The International Society of Sports Nutrition's 2025 review of creatine misconceptions reached the same point: studies in people hypertensive at baseline "are missing from the literature" (quoted and discussed on creatine and medical conditions).
So the honest statement is narrow. No study has shown creatine raising blood pressure in people with normal pressure. No study has looked at people with high blood pressure, or at people taking blood-pressure medicines alongside creatine. Anyone in either group should take the question to their clinician.
A cohort finding that points the other way
One study is often cited against creatine, and it deserves to be read precisely. In the Dutch PREVEND cohort, researchers measured fasting plasma creatine — the creatine naturally circulating in blood — in 3,135 adults without hypertension and followed them for a median of 7.1 years; 927 developed hypertension. Each doubling of plasma creatine was associated with a 21% higher risk (hazard ratio 1.21, 95% CI 1.10–1.34). Split by sex, the association held in men (HR 1.26) but not in women (HR 1.13, not significant) (Post et al., J Hypertens 2022, PMID 34371517).
What it does not show:
- It is not about supplements. Participants were a general population; plasma creatine reflects diet, muscle mass and the body's own production. The paper does not report supplement use.
- It is an association. People with more muscle, a higher meat intake or different kidney handling may differ in other ways that affect blood pressure. The authors adjusted for several confounders and still call for studies of the mechanism.
- The cohort was enriched for people with high urinary albumin, a kidney-damage marker, so it is not a random sample.
Two co-authors were employees of the laboratory company that ran the measurements, which the paper discloses. The finding is a reason the hypertension trial matters, not evidence that supplements raise blood pressure.
Creatine kinase is a different molecule
Searches for creatine and blood pressure return dozens of papers about creatine kinase, the enzyme that moves energy between creatine and ATP. High creatine kinase has been linked to high blood pressure in observational work, summarised in a 2019 systematic review (Brewster et al., Med Sci 2019, PMID 30970679). Creatine kinase rises with muscle mass and muscle damage, and those papers say nothing about taking creatine. MuscleLedger's PubMed search on 2026-10-15 for creatine in the title with "blood pressure", "hypertension" or "arterial stiffness" returned 194 records; most of the first 20 were about the enzyme or about animals.
Where the water-retention worry fits
The water creatine draws in goes into muscle cells. In a five-day loading trial, all body-water compartments measured by bioimpedance rose (Weiss and Powers 2006), and the blood-pressure trials above found no matching rise in pressure. Fluid and hydration questions are on creatine and dehydration; the scale weight and puffiness on creatine bloating.
What FDA's adverse-event reports contain
MuscleLedger queried FDA's CFSAN Adverse Event Reporting System through the openFDA food-event interface on 2026-10-15 (dataset last updated 2026-07-07) for reports naming a product with "creatine" in its brand name and coding "blood pressure increased", "hypertension" or "hypertensive crisis". Twelve reports matched, dated 2004 to 2025.
| What the report named | Reports |
|---|---|
| Two or more products | 9 |
| …of which at least one fat burner or pre-workout formula was also listed | 4 |
| One product: a branded creatine blend (2004, 2011) | 2 |
| One product: creatine gummies (2025) | 1 |
| One product: plain creatine monohydrate | 0 |
Two of the twelve reports concern 16-year-old boys; one names a testosterone-booster-and-creatine product taken with a pre-workout formula. Outcomes recorded include two life-threatening events, two hospitalisations and several emergency visits.
These reports cannot establish that creatine raised anyone's blood pressure. They have no denominator, they record what the reporter chose to list, and most named several products, some containing stimulants. They are listed so the reader can see what the database holds, rather than a single total. The full creatine report set, and why it cannot be compared with the trial evidence, is discussed on creatine side effects.
What is not established
- The effect of creatine in people with high blood pressure. No trial.
- The effect alongside blood-pressure medicines. No trial.
- Whether creatine lowers blood pressure. One small, unbalanced trial hints at it without reaching significance.
- Long-term effects beyond two years. Not measured.
Teenagers are a separate case, discussed on creatine for teens. Older adults are covered on creatine for older adults.
Sources
All opened 2026-10-15.
- Mihic S et al. "Acute creatine loading increases fat-free mass, but does not affect blood pressure, plasma creatinine, or CK activity in men and women." Med Sci Sports Exerc 2000;32(2):291–6. PMID 10694109
- Weiss BA, Powers ME. J Sports Med Phys Fitness 2006;46(4):555–63. PMID 17119520
- Galvan E et al. "Acute and chronic safety and efficacy of dose dependent creatine nitrate supplementation and exercise performance." JISSN 2016. PMID 27034623
- Dalton RL et al. "Hematological and hemodynamic responses to acute and short-term creatine nitrate supplementation." Nutrients 2017. PMID 29244743
- Aron A et al. "Effects of acute creatine supplementation on cardiac and vascular responses in older men; a randomized controlled trial." Clin Nutr ESPEN 2024;63:557–63. PMID 39047868
- Clarke HE et al. "Effect of creatine monohydrate supplementation on macro- and microvascular endothelial function in older adults: a pilot study." Nutrients 2024. PMID 39796490
- Horjus DL et al. "Creatine and creatine analogues in hypertension and cardiovascular disease." Cochrane Database Syst Rev 2011. PMID 22071819
- Post A et al. "Plasma creatine concentration is associated with incident hypertension…: the PREVEND study." J Hypertens 2022;40(2):229–39. PMID 34371517
- Brewster LM et al. "Creatine kinase and blood pressure: a systematic review." Med Sci 2019. PMID 30970679
- ClinicalTrials.gov API v2, intervention "creatine", condition "hypertension", searched 2026-10-15.
- FDA CFSAN Adverse Event Reporting System via openFDA food event API, queried 2026-10-15.