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

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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

DOI 10.3945/an.117.016717PMC PMC5683004

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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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“Interestingly, some of these antihypertensive effects appear to be independent of nitrate content, which suggests that there are synergistic interactions with other phytochemicals [22].”

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
ORCID: Bahadoran, Zahra
Mirmiran, Parvin
Kabir, Ali
Azizi, Fereidoun
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
DOI: 10.3945/an.117.016717
PMC: PMC5683004
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: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 1548 d)
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 (medical) › 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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The Nitrate-Independent Blood Pressure–Lowering Effect of Beetroot Juice: A Systematic Review and Meta-Analysis

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