Ageing modifies the effects of beetroot juice supplementation on 24-hour blood pressure variability: An individual participant meta-analysis
Open accessAbstract
Objectives Abnormal circadian oscillations of blood pressure (BP) and nocturnal-diurnal BP differences (i.e., dipping) increase cardiovascular risk. Whether inorganic nitrate supplementation influences 24-hr BP variability is currently unknown. We studied the effects of high-nitrate beetroot juice supplementation on BP variability measured by 24-hr ambulatory BP monitoring (24-hr ABPM) in older subjects.Methods Data from four independent randomised clinical trials were collated. Eighty-five older participants (age range: 55-76 years) were included in the final database. Two trials had an open-label, parallel design and two trials had a cross-over, double-blind design. Participants were randomised to either beetroot juice or placebo. Changes in 24-hr ABPM (daily, diurnal, nocturnal), variability (weighted-SDs), night-dipping, morning surge for systolic and diastolic BP were measured. Meta-analysis was conducted to obtain pooled estimates of the effect size for each BP outcome. Sub-group analyses were conducted to evaluate the influence of age, BMI, gender, BP status and changes in nitrite concentrations on the effect size.Results The pooled effect of beetroot juice on all BP outcomes was not significant. Beetroot juice ingestion determined a significant decrease in nocturnal systolic BP variability in subjects aged less than 65 y (2.8 mmHg, -4.5 -1.0, p = 0.002) compared to the older group (≥ 65 y; 1.0 mmHg, -2.2 4.2, p = 0.54). A greater change in NO2(-) concentrations after beetroot supplementation was associated with significant differences for nocturnal mean (-3.4 mmHg, -0.6 -2.4, p = 0.02) and variability (-0.8 mmHg, -1.5 -0.06, p = 0.03) of systolic BP.Conclusions The vascular responsiveness to inorganic nitrate may be modified by mechanisms of vascular ageing influencing the reducing capacity to convert inorganic nitrate into nitrite and tissue-specific responses to dietary nitrate supplementation.
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While the efficacy of dietary nitrate to reduce systemic blood pressure in older age has been extensively studied, relatively few studies have assessed the effects of nitrate supplementation on exercise capacity in healthy older individuals.
“While the efficacy of dietary NO 3 -to reduce systemic blood pressure in older age has been extensively studied (reviewed in 140; see also 139, 142), relatively few studies have assessed the effects of NO 3 -supplementation on exercise capacity in healthy older individuals.”
From Dietary Nitrate and Physical Performance (2018) · cites this paper as [139]
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- Authors
- Siervo, M., Lara, J., Jajja, A., Sutyarjoko, A., Ashor, A. W., Brandt, K., Qadir, O., Mathers, J. C., Benjamin, N., Winyard, P. G., Anning, C., Shore, A., & Gilchrist, M.
- Affiliations
- Newcastle University (GB)
- University of Sulaimani (IQ)
- University of Exeter (GB)
- Corresponding author
- Siervo, M.
- ORCID
- Venue
- Nitric Oxide
- Publisher
- Elsevier BV
- Published
- 2015-05
- Volume
- 47
- Pages
- 97-105
- ISSN
- 1089-8603 (ISSN-L)
- OpenAlex
- W2012264067
- Cited by
- 52
- References
- 44
- Citations by year
- 2026: 2 · 2025: 1 · 2023: 1 · 2022: 9 · 2021: 8 · 2020: 3 · 2019: 7 · 2018: 6 · 2017: 12 · 2016: 2
- FWCI
- 1.15
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- cc-by-nc-nd
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- Locations
- Nitric Oxide (publishedVersion)
- PubMed (publishedVersion)
- Open Research Exeter (University of Exeter) (acceptedVersion, cc-by-nc-nd)
- Figshare (submittedVersion)
- Royal Devon and Exeter Research Repository (Royal Devon and Exeter) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- Newcastle University
- NIHR
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Keywords
- beetroot juice, inorganic nitrate, nitrite, blood pressure variability, nocturnal blood pressure dipping, circadian blood pressure rhythm, vascular aging, older adults, ambulatory blood pressure monitoring, nitrate-nitrite-nitric oxide pathway, vascular response
- MeSH terms
- Aged, Aging, Beverages, Blood Pressure, Female, Humans, Male, Middle Aged, Nitrates, Nitrites, Time Factors, Blood Pressure Monitoring, Ambulatory, Dietary Supplements, Beta vulgaris
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