Cited by 150Blood Pressure and Hypertension StudiesCardiovascular Health and Disease PreventionNitric Oxide and Endothelin Effects

The Nitrate-Independent Blood Pressure–Lowering Effect of Beetroot Juice: A Systematic Review and Meta-Analysis

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Bahadoran, Zahra, Mirmiran, Parvin, Kabir, Ali, Azizi, Fereidoun, Ghasemi, Asghar·2017·Advances in Nutrition

Abstract

Beetroot is considered a complementary treatment for hypertension because of its high content of inorganic NO 3 This systematic review and meta-analysis aimed to clarify several aspects of beetroot juice supplementation on systolic blood pressure (SBP) and diastolic blood pressure (DBP). We searched PubMed, Scopus, and Embase databases, and the reference lists of previous reviews. Randomized clinical trials that investigated the effects of beetroot juice on resting blood pressure in humans were recruited for quality assessment, meta-analyses, subgroup analyses, and meta-regressions; of these, 22 were conducted between 2009 and 2017 and included a total of 47 intervention (n = 650) and 43 control (n = 598) groups. Overall, SBP (-3.55 mm Hg; 95% CI: -4.55, -2.54 mm Hg) and DBP (-1.32 mm Hg; 95% CI: -1.97, -0.68 mm Hg) were significantly lower in the beetroot juice-supplemented groups than in the control groups. The mean difference of SBP was larger between beetroot juice-supplemented and control groups in the longer than in the shorter (≥14 compared with <14 d) study durations (-5.11 compared with -2.67 mm Hg) and the highest compared with the lowest (500 compared with 70 and 140 mL/d) doses of beetroot juice (-4.78 compared with -2.37 mm Hg). A positive correlation was observed between beetroot juice doses and the mean differences of blood pressures. In contrast, a smaller effect size of blood pressures was observed after supplementation with higher NO 3 (milligrams per 100 mL beetroot juice). A weak effect size was observed in a meta-analysis of trials that used NO 3-depleted beetroot juice as a placebo compared with other interventions (-3.09 compared with -4.51 mm Hg for SBP and -0.81 compared with -2.01 mm Hg for DBP). Our results demonstrate the blood pressure-lowering effects of beetroot juice and highlight its potential NO 3-independent effects.

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Crossref · 10.3945/an.117.016717

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Authors
Bahadoran, Z., Mirmiran, P., Kabir, A., Azizi, F., & Ghasemi, A.
Affiliations
  • Research Institute for Endocrine Sciences (IR)
  • National Nutrition and Food Technology Research Institute (IR)
  • Iran University of Medical Sciences (IR)
Corresponding author
Ghasemi, Asghar
Venue
Advances in Nutrition
Publisher
Elsevier BV
Published
2017-11
Volume
8
Issue
6
Pages
830-838
ISSN
  • 2156-5376 (ISSN-L)
  • 2161-8313
OpenAlex
W2772708097
Cited by
150
References
40
Citations by year
2026: 19 · 2025: 16 · 2024: 14 · 2023: 26 · 2022: 18 · 2021: 20 · 2020: 18 · 2019: 11 · 2018: 7 · 2017: 1
FWCI
1.43
Type
journal article
Language
en
Update notices
erratum (2018-05-01)
Open access
Locations
  • Advances in Nutrition (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
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 › Medicine › Physiology › Nitric Oxide and Endothelin Effects
Keywords
beetroot juice, blood pressure reduction, hypertension, systolic blood pressure, diastolic blood pressure, dietary nitrate, dietary supplementation, dose-response relationship
MeSH terms
Fruit and Vegetable Juices, Adult, Antihypertensive Agents, Blood Pressure, Female, Humans, Hypertension, Male, Middle Aged, Nitrates, Dietary Supplements, Beta vulgaris

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