Very low-calorie ketogenic diet reduces central blood pressure and cardiometabolic risk in post-menopausal women with essential hypertension and obesity: a single-center, prospective, open-label, clinical study.

BACKGROUND AND AIMS: Obesity represents a crucial modifiable risk factor for cardiovascular complications. Two dietary approaches, Very Low-Calorie Ketogenic (VLCKD) and Intermittent Fasting (IFD) diets, have demonstrated to reduce blood pressure (BP) and produce cardiovascular and metabolic advantages. We aimed to evaluate the effects of VLCKD or IFD compared to Free Diet (FD) on office brachial and central systolic BP levels. Secondary outcomes included changes from baseline of diastolic BP and several weight-related indexes.

METHODS AND RESULTS: In this single-center, open-label, prospective clinical study, post-menopausal women with treated uncomplicated hypertension and obesity were assigned to 3 dietary programs: VLCKD, IF, and FD. All patients underwent BP measurements, dietary consultation with personalized dietary program, and blood tests for metabolic parameters. All outcome variables were measured at baseline (T0), two (T1) and six months (T2). We included 18 patients in the VLCKD, 16 in the IFD and 9 in the FD groups, respectively. At T2 VLCKD patients showed significantly lower brachial systolic (p = 0.005) and diastolic (p = 0.038), central systolic (p = 0.02) and diastolic (p = 0.03) BP levels than those in other groups. VLCKD also induced reductions in weight (p = 0.03), WC (p < 0.01), WHR (p < 0.01), BFP (p < 0.01); TOT-C (p = 0.01), LDL-C (p < 0.01), and triglycerides (p = 0.02). No relevant changes were observed in IF and FD groups.

CONCLUSIONS: KD emerged as the clear front-runner in reducing brachial and central office systolic/diastolic BP levels and weight-related parameters in post-menopausal women with treated hypertension and obesity.