Does apple cider vinegar lower blood pressure?

Maybe slightly, and the evidence is about vinegar in general rather than apple cider vinegar. A 2022 dose-response meta-analysis of randomized trials found that each 2 tbsp (30 mL) a day of vinegar went with systolic pressure 3.25 mmHg lower and diastolic 3.33 mmHg lower, and the authors rated the certainty of both as low. We found no randomized trial that tested apple cider vinegar for blood pressure, and the meta-analyses of apple cider vinegar itself did not report blood pressure at all.

Unsettled. The answer is unclear for three reasons we can name. The one pooled result mixes vinegars of every type. Its abstract does not say how many trials or people it holds, and we could not get the full text. And the trials disagreed with each other a good deal, and the authors rated the certainty as low.

What the trials found

Vinegar of any kind

The 2022 meta-analysis searched for randomized trials of vinegar in adults up to April 2022 and modeled dose against effect. Per 2 tbsp (30 mL) a day, systolic pressure fell by 3.25 mmHg, with a confidence interval from 0.96 to 5.54, and diastolic by 3.33 mmHg, interval 2.49 to 4.16. The effect looked linear up to 2 tbsp (30 mL) a day. Heterogeneity was substantial for systolic pressure, at 67.5%, and moderate for diastolic, at 57.1%. The authors still suggest vinegar as a helper for blood pressure, which is a stronger recommendation than their own low certainty rating supports.

Apple cider vinegar itself

The largest meta-analysis of apple cider vinegar, 25 trials in 1,320 adults, set out to study blood sugar and blood fats, and its abstract reports no blood pressure result. A 2021 meta-analysis of 16 randomized trials of acetic acid in 910 adults, at 750 to 3600 mg of acetic acid a day for at least a week, pooled glucose, blood fats, BMI and body fat, with no blood pressure analysis either. That is a gap in what was measured or reported. It is not a finding that apple cider vinegar does nothing.

Where the idea comes from

In spontaneously hypertensive rats, long-term acetic acid, the main acid in vinegar, lowered blood pressure and renin activity against controls. Renin is a hormone that helps raise blood pressure, and this is the main proposed mechanism. The study was in rats, its authors worked for a vinegar maker, and the abstract gives no size for the fall in pressure.

Who should be careful

Not for everyone. Vinegar is an acid, and the harms on record come from that. In a crossover trial of 16 healthy young adults, vinegar with breakfast lowered appetite and raised nausea ratings, most of all with the less palatable drink. Dutch dentists traced erosive tooth wear in a 15-year-old girl to a daily glass of apple cider vinegar drunk to lose weight, a single case that shows how the harm happens rather than how often. After a throat injury from an apple cider vinegar tablet, tests of 8 tablet brands found tablet size, acidity and label claims varied widely, on product data from 2005.

None of these studies measured blood pressure. We found no evidence on vinegar in people taking blood pressure medicines, in pregnancy or in children, and that absence is not reassurance. If you have high blood pressure, vinegar is not a substitute for treatment that has been tested.

What expert bodies say

We looked for a position from a heart, blood pressure or nutrition body on vinegar and found none. No expert body we searched recommends apple cider vinegar for blood pressure, and none advises against it on these grounds either.

How we searched

What would change this answer

• A placebo-controlled trial of apple cider vinegar with 24-hour blood pressure as the main outcome. We found none. The closest registered trial is of rice vinegar in people with prehypertension.
• The trial list behind the 2022 meta-analysis, to see how many trials used apple cider vinegar.
• Blood pressure results from the apple cider vinegar trials already done, if they were measured.
• Any data on vinegar alongside blood pressure medicines.

More on this food: apple cider vinegar and weight loss.

Sources

1. ev-acvbp-01 · Meta-analysis or systematic review · systematic review and dose-response meta-analysis of RCTs with GRADE · n = —
   Each 30 ml/d increment in vinegar consumption reduced SBP by - 3.25 mmHg (95 %CI: - 5.54, - 0.96; I2 = 67.5 %, GRADE = low).
   
   Who: adults in randomized controlled trials of vinegar (any type, not only apple cider vinegar), searched to April 2022
   Effect: systolic BP MD -3.25 mmHg per 30 mL/day (95% CI -5.54 to -0.96); I2 67.5%; GRADE low
   Certainty: Number of RCTs and participants not given in the abstract; full text not in PMC. Vinegar of various types, not only apple; outside the corpus snapshot.
   Complementary Therapies in Medicine, 2022 (dose-response meta-analysis of vinegar and blood pressure) · checked 2026-10-07 · we read the abstract
2. ev-acvbp-02 · Meta-analysis or systematic review · systematic review and dose-response meta-analysis of RCTs with GRADE · n = —
   Each 30 ml/d increment in vinegar consumption reduced DBP by - 3.33 mmHg (95 %CI: - 4.16, - 2.49; I2 = 57.1 %, GRADE = low).
   
   Who: adults in randomized controlled trials of vinegar, searched to April 2022
   Effect: diastolic BP MD -3.33 mmHg per 30 mL/day (95% CI -4.16 to -2.49); I2 57.1%; GRADE low; effect linear up to 30 mL/day
   Certainty: The authors recommend vinegar as an adjunct, but their own assessment of the evidence is low; discrepancy between conclusion and certainty.
   Complementary Therapies in Medicine, 2022 (dose-response meta-analysis of vinegar and blood pressure) · checked 2026-10-07 · we read the abstract
3. ev-acvbp-03 · Meta-analysis or systematic review · systematic review and meta-analysis of clinical trials · n = 1320
   The present study aimed to perform a systematic review and meta-analysis of the effects of ACV consumption on lipid and glycemic parameters.
   
   Who: adults in 25 clinical trials (33 arms) of apple cider vinegar
   Effect: fasting glucose -21.20 mg/dL, HbA1c -0.91, total cholesterol -6.72 mg/dL; blood pressure not among the stated aims or abstract results
   Certainty: The conclusion that there are no blood pressure data is drawn from the abstract (aim: lipids and glycemia); full text unavailable.
   Current Medicinal Chemistry, 2025 (meta-analysis of apple cider vinegar and cardiometabolic risk factors) · checked 2026-10-07 · we read the abstract
4. ev-acvbp-04 · Meta-analysis or systematic review · systematic review and meta-analysis of RCTs · n = 910
   Meta-analyses were performed using a random-effects model on fasting blood glucose (FBG), triacylglycerol (TAG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), glycated hemoglobin (HbA1c), body mass index (BMI), and body fat percentage.
   
   Who: adults in RCTs of dietary acetic acid from vinegar beverages and foods for at least 1 week, 750 to 3600 mg a day
   Effect: outcomes pooled: fasting glucose, triglycerides, HDL, LDL, HbA1c, BMI, body fat; blood pressure not analyzed
   Certainty: The absence of blood pressure among the endpoints is a gap, not a null result.
   J Acad Nutr Diet, 2021 · checked 2026-10-07 · we read the abstract
5. ev-acvbp-05 · Laboratory or animal data · animal study · n = —
   As a result, it was observed that acetic acid itself, the main component of vinegar, significantly reduced both blood pressure (p<0.05) and renin activity (p<0.01) compared to controls given no acetic acid or vinegar, as well as vinegar.
   
   Who: spontaneously hypertensive rats given vinegar or acetic acid long term
   Effect: blood pressure lower (p < 0.05) and renin activity lower (p < 0.01) than controls; no change in ACE activity
   Certainty: Animal model; the authors are from a vinegar manufacturer (Mizkan). No size of blood pressure reduction in the abstract.
   Bioscience, Biotechnology, and Biochemistry, 2001 (Kondo et al.) · checked 2026-10-07 · we read the abstract
6. ev-acvbp-06 · Randomized controlled trial(s) · randomized crossover acute feeding study · n = 16
   In Study 1, ingestion of vinegar significantly reduced quantitative and subjective measures of appetite, which were accompanied by significantly higher nausea ratings, with unpalatable treatment having the greatest effect.
   
   Who: healthy, young, normal weight unrestrained eaters, Study 1
   Effect: significantly higher nausea ratings after vinegar; appetite also lower
   Certainty: Single meal; blood pressure not measured. For enamel erosion and esophageal burn from tablets see ev-acvw-06, ev-acvw-07.
   Int J Obes (Lond), 2014 · checked 2026-10-07 · we read the abstract
7. ev-acvw-06 · Laboratory or animal data · case report · n = 1
   Erosive tooth wear was diagnosed in the dentition of a 15-year-old girl with a Moroccan background. After an anamnesis, extensive analysis of possible risk factors and a study of the pattern of erosion, it was concluded that the erosive tooth wear was induced by daily consumption of a glass of apple cider vinegar
   
   Who: one 15-year-old girl
   Effect: erosive tooth wear attributed to daily apple cider vinegar
   Certainty: Single case; shows the mechanism of harm, not how often it happens.
   Nederlands Tijdschrift voor Tandheelkunde, 2012, 119(12):589-91 · checked 2026-10-06 · we read the abstract
8. ev-acvw-07 · Laboratory or animal data · case report with laboratory product analysis · n = 8 products
   Considerable variability was found between the brands in tablet size, pH, component acid content, and label claims.
   
   Who: eight apple cider vinegar tablet products tested after one reported adverse event
   Effect: considerable variability in tablet size, pH, acid content and label claims
   Certainty: One injury case; the product data date from 2005.
   Journal of the American Dietetic Association, 2005, 105(7):1141-4 · checked 2026-10-06 · we read the abstract