Nitrate Derived From Beetroot Juice Lowers Blood Pressure in Patients With Arterial Hypertension: A Systematic Review and Meta-Analysis
What this study found
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.
- Study & population
- Systematic review and meta-analysis of 7 randomized controlled trials including 218 adults with arterial hypertension or elevated blood pressure.
- Intervention
- 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.
- Key limitation
- The evidence base was small, with only 7 short-term trials and 218 participants in total.
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Open PDFOriginal abstract
Background Although there are a considerable number of clinical studies on nitrate (NO3) rich beetroot juice (BRJ) and hypertension, it is difficult to indicate the real effects of NO3 from BRJ on the BP of hypertensive patients because there are still no estimates of the effects of NO3 derived from BRJ on the BP of hypertension patients. Objective To clarify these effects, we developed a systematic literature review with a meta-analysis of randomized clinical trials (RCTs). Design The searches were accomplished through EMBASE, Cochrane Library, MEDLINE, CINAHL, Web of Science, and LILACS databases. The study included single or double-blinded RCTs and participants older than 18 years with hypertension [systolic BP (SBP) > 130 mmHg and diastolic BP (DBP) > 80 mmHg]. NO3 BRJ was required to be consumed in a format that possibly blinded participants/researchers. These studies should also report the SBP and DBP values (mmHg) measured before and after the treatment. Risk of Bias tools and GRADE were enforced. Results Seven studies were included (218 participants). BRJ intervention time ranged from 3 to 60 days with daily dosages of 70–250 mL of BRJ. After the intervention with NO3 from BRJ, SBP underwent significant changes (p < 0.001) of −4.95 (95% CI: −8.88; −1.01) (GRADE: ⊕⊕⊕○ Moderate), but not for DBP (p = 0.06) −0.90 mmHg (95% CI: −3.16; 1.36) (GRADE: ⊕⊕⊕○ Moderate), compared to the control group. Conclusions The NO3 derived from BRJ reduces SBP, but not DBP in patients with arterial hypertension. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=269339.