Nitrate Derived From Beetroot Juice Lowers Blood Pressure in Patients With Arterial Hypertension: A Systematic Review and Meta-Analysis

Systematic review and meta-analysis of 7 randomized controlled trials including 218 adults with arterial hypertension or elevated blood pressure. Participants were recruited from Brazil, Australia, the United States, the United Kingdom, and Ireland, with a mix of treated and untreated patients and clinic or ambulatory blood pressure outcomes.

The active intervention was nitrate derived from beetroot juice, delivered as beetroot juice in doses ranging from 70 to 250 mL and nitrate doses from 6.2 to 12.8 mmol, depending on the trial. Regimens were short term, ranging from 3 days to 4 weeks, and were compared with nitrate-depleted beetroot juice or other control conditions in the included studies.

Nitrate derived from beetroot juice lowered systolic blood pressure in adults with arterial hypertension, but diastolic blood pressure was not significantly affected overall. The benefit was more evident for clinic blood pressure than for 24-hour ambulatory monitoring. Across the included trials, the pooled evidence was based on 7 studies and 218 participants, and the certainty of evidence was moderate. The authors concluded that longer-term studies are needed to determine whether the effect is sustained and to better characterize safety.

The evidence base was small, with only 7 short-term trials and 218 participants in total. Doses, nitrate content, treatment durations, and blood pressure measurement methods varied across studies, which increases heterogeneity and limits direct comparability. Longer-term efficacy and safety were not established.