Background: High salt diets are associated with increased blood pressure (BP) and heightened cardiovascular disease risk, particularly with aging. Currently, the average American adult consumes 45-50% more sodium than the recommended 2,300mg/day. Preclinical data have documented that nutritional ketosis (i.e., increasing beta-hydroxybutyrate; β-OHB) may be efficacious in lessening the effects of high salt on BP. Therefore, we sought to translate these findings in humans by examining 24-hour ambulatory BP patterns after short-term high salt and ketone supplementation in middle-aged and older adults. Methods: Ten adults (6 F/4 M, age 63.5±6.4 years, BMI 26.2±4.1kg/m2; mean ± SD) completed a randomized, crossover study consisting of three 10-day conditions: low salt (LS): placebo capsules (dextrose) and placebo drink; high salt (HS): salt capsules and placebo drink; high salt + ketone (HS+K): salt capsules and ketone drink. Participants were counseled to consume a low sodium diet (~0.8 Na + /kcal/day) for all conditions and supplemented to a high sodium diet (~2 Na + /kcal/day) for HS conditions. Ketone monoester drinks provided 36 g β-OHB/day. For ambulatory BP, participants wore a BP monitor programmed to measure brachial BP every 20 minutes during awake hours and every 30 minutes during sleep. Awake and asleep hours were adjusted to self-reported bedtime hours. We calculated BP dipping as the percentage drop in BP from awake to sleep as: % dip = (awake BP - sleep BP) / awake BP × 100. For statistical analysis, we used one-way ANOVAs (supplement condition) and set α a priori to ≤ 0.05. Results: Overall systolic BP (LS: 117±10 vs. HS: 126±19 vs. HS+K: 123±17 mmHg, p=0.490), awake systolic BP (LS: 121±9 vs. HS: 129±19 vs. HS+K: 127±19 mmHg, p=0.527), asleep systolic BP (LS: 108±12 vs. HS: 120±23 vs. HS+K: 114±16 mmHg, p=0.377), and systolic BP % dip (LS: 10.3%±7% vs. HS: 7.1%±7% vs. HS+K: 10.1%±8%, p=0.605) did not differ across conditions. Similarly, overall diastolic BP (p=0.810) and mean BP (p=0.861), awake diastolic BP (p=0.869) and mean BP (p=0.923), and asleep diastolic BP (p=0.573) and mean BP (p=0.659) did not differ across conditions. The diastolic BP % dip (p=0.726) and mean BP % dip (p=0.729) also did not differ across conditions. Conclusion: These preliminary data suggests that there were no significant differences in 24-hour ambulatory BP with salt or ketone supplementation in middle-aged and older adults. However, given promising directional differences across conditions, we plan to reexamine our findings in a larger sample size. This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.
Aldridge et al. (Fri,) studied this question.