Creatine safe with people with diagnosed hypertension?

A buddy of mine was inquiring about whether it’s recommended for people with hypertension who are on medications to stay away from creatine? For reference, he’s in his late 20’s, has diagnosis of hypertension which is well controlled on two medications. Does not have any other comorbidities besides obesity. Does have family history of Hypertension in parents. Otherwise a healthy young male who is looking to optimize his gym gainzz. Would it be an absolute vs. relative contraindication for those with hypertension to take creatine?

Pedantic response incoming…

Supplemental creatine is not really recommended or prescribed for any specific health condition. There are threads of evidence showing their may be an improvement in some measurements of cognition, but it’s not super clear how reliable those findings are. Similarly, creatine has been investigated after heart attacks, pregnancy, in children with cerebral palsy, and many other clinical settings with relatively little hard clinical data coming from these studies. I suspect we’ll know more in the future, but for now, my impression of dietary creatine is that folks in the fitness space overplay it’s potential benefit on health and performance whereas doctors have little to no idea what it is.

I suspect you were asking if it’s safe for an individual with well-controlled hypertension to take supplemental creatine. Short answer, we don’t really know, as this has never been studied. That said, creatine shouldn’t affect blood pressure at all either, save for the risk of contamination in the supplement being used. I can’t tell you whether or not your friend should or shouldn’t use supplemental creatine, but I do not personally view hypertension as an absolute contraindication to creatine supplementation. I would have to know more about the patient, their history, preferences, etc. to come to a shared decision about use.