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The Nitrate-Independent Blood Pressure–Lowering Effect of Beetroot Juice: A Systematic Review and Meta-Analysis
Open accessAbstract
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].”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [22]
Citations
Cites
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139
PRISMA-P Group, Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Shekelle, P., & Stewart, L. A. (2015) · Systematic Reviews · doi:10.1186/2046-4053-4-1 · Cited by 26,223
Chobanian, A. V. (2003) · JAMA · doi:10.1001/jama.289.19.2560 · Cited by 25,386
Mills, K. T., Bundy, J. D., Kelly, T. N., Reed, J. E., Kearney, P. M., Reynolds, K., Chen, J., & He, J. (2016) · Circulation · doi:10.1161/circulationaha.115.018912 · Cited by 3,531
The nitrate-nitrite-nitric oxide pathway in physiology and therapeutics
Lundberg, J. O., Weitzberg, E., & Gladwin, M. T. (2008) · Nature Reviews Drug Discovery · doi:10.1038/nrd2466 · Cited by 2,739 · cited 1×
“important physiologic mediator in regulating blood pressure (11).”
BackgroundWebb, A. J., Patel, N., Loukogeorgakis, S., Okorie, M., Aboud, Z., Misra, S., Rashid, R., Miall, P., Deanfield, J., Benjamin, N., et al. (2008) · Hypertension · doi:10.1161/hypertensionaha.107.103523 · Cited by 1,078
Bailey, S. J., Winyard, P., Vanhatalo, A., Blackwell, J. R., DiMenna, F. J., Wilkerson, D. P., Tarr, J., Benjamin, N., & Jones, A. M. (2009) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00722.2009 · Cited by 759
The Potential Benefits of Red Beetroot Supplementation in Health and Disease
Clifford, T., Howatson, G., West, D., & Stevenson, E. (2015) · Nutrients · doi:10.3390/nu7042801 · Cited by 635
Bailey, S. J., Fulford, J., Vanhatalo, A., Winyard, P. G., Blackwell, J. R., DiMenna, F. J., Wilkerson, D. P., Benjamin, N., & Jones, A. M. (2010) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00046.2010 · Cited by 607
Beyond Medications and Diet: Alternative Approaches to Lowering Blood Pressure
Brook, R. D., Appel, L. J., Rubenfire, M., Ogedegbe, G. G., Bisognano, J. D., Elliott, W. J., Fuchs, F. D., Hughes, J. W., Lackland, D. T., Staffileno, B. A., et al. (2013) · Hypertension · doi:10.1161/hyp.0b013e318293645f · Cited by 604
Vanhatalo, A., Bailey, S. J., Blackwell, J. R., DiMenna, F. J., Pavey, T. G., Wilkerson, D. P., Benjamin, N., Winyard, P. G., & Jones, A. M. (2010) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00206.2010 · Cited by 529
Kapil, V., Khambata, R. S., Robertson, A., Caulfield, M. J., & Ahluwalia, A. (2015) · Hypertension · doi:10.1161/hypertensionaha.114.04675 · Cited by 500
Lansley, K. E., Winyard, P. G., Fulford, J., Vanhatalo, A., Bailey, S. J., Blackwell, J. R., DiMenna, F. J., Gilchrist, M., Benjamin, N., & Jones, A. M. (2011) · Journal of Applied Physiology · doi:10.1152/japplphysiol.01070.2010 · Cited by 404
Siervo, M., Lara, J., Ogbonmwan, I., & Mathers, J. C. (2013) · The Journal of Nutrition · doi:10.3945/jn.112.170233 · Cited by 375
Nitrate Supplementation’s Improvement of 10-km Time-Trial Performance in Trained Cyclists
Cermak, N. M., Gibala, M. J., & van Loon, L. J. C. (2012) · International Journal of Sport Nutrition and Exercise Metabolism · doi:10.1123/ijsnem.22.1.64 · Cited by 326
Velmurugan, S., Gan, J. M., Rathod, K. S., Khambata, R. S., Ghosh, S. M., Hartley, A., Van Eijl, S., Sagi-Kiss, V., Chowdhury, T. A., Curtis, M., et al. (2016) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.115.116244 · Cited by 284
Gilchrist, M., Winyard, P. G., Aizawa, K., Anning, C., Shore, A., & Benjamin, N. (2013) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2013.01.024 · Cited by 261 · cited 2×
“Despite the fact that our results differ from current views that have attributed the hypotensive effect of beetroot to inorganic NO3, apparently beyond NO3 content, beetroot exerts its beneficial effects through other bioactive compounds such as polyphenols, a concept also supported by findings from previous studies t…”
BackgroundResultA General Framework for the Evaluation of Clinical Trial Quality
Berger, V. W., & Alperson, S. Y. (2009) · Reviews on Recent Clinical Trials · doi:10.2174/157488709788186021 · Cited by 253
Kelly, J., Fulford, J., Vanhatalo, A., Blackwell, J. R., French, O., Bailey, S. J., Gilchrist, M., Winyard, P. G., & Jones, A. M. (2013) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00406.2012 · Cited by 232
Hobbs, D. A., Kaffa, N., George, T. W., Methven, L., & Lovegrove, J. A. (2012) · British Journal Of Nutrition · doi:10.1017/s0007114512000190 · Cited by 199
Eggebeen, J., Kim-Shapiro, D. B., Haykowsky, M., Morgan, T. M., Basu, S., Brubaker, P., Rejeski, J., & Kitzman, D. W. (2016) · JACC: Heart Failure · doi:10.1016/j.jchf.2015.12.013 · Cited by 190
Coles, L. T., & Clifton, P. M. (2012) · Nutrition Journal · doi:10.1186/1475-2891-11-106 · Cited by 167
Nitrate Supplementation Enhances the Contractile Properties of Human Skeletal Muscle
HAIDER, G., & FOLLAND, J. P. (2014) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000000351 · Cited by 166
Beetroot supplementation lowers daily systolic blood pressure in older, overweight subjects
Jajja, A., Sutyarjoko, A., Lara, J., Rennie, K., Brandt, K., Qadir, O., & Siervo, M. (2014) · Nutrition Research · doi:10.1016/j.nutres.2014.09.007 · Cited by 138
Bondonno, C. P., Liu, A. H., Croft, K. D., Ward, N. C., Shinde, S., Moodley, Y. P., Lundberg, J. O., Puddey, I. B., Woodman, R. J., & Hodgson, J. M. (2015) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.114.101188 · Cited by 114
Ashor, A. W., Lara, J., & Siervo, M. (2017) · Journal of Hypertension · doi:10.1097/hjh.0000000000001305 · Cited by 98
Asgary, S., Afshani, M. R., Sahebkar, A., Keshvari, M., Taheri, M., Jahanian, E., Rafieian‐Kopaei, M., Malekian, F., & Sarrafzadegan, N. (2016) · Journal of Human Hypertension · doi:10.1038/jhh.2016.34 · Cited by 97
Treatment efficacy of anti-hypertensive drugs in monotherapy or combination
Paz, M., de-La-Sierra, A., Sáez, M., Barceló, M. A., Rodríguez, J. J., Castro, S., Lagarón, C., Garrido, J. M., Vera, P., & de Tuero, G. C. (2016) · Medicine · doi:10.1097/md.0000000000004071 · Cited by 96
Shepherd, A. I., Wilkerson, D. P., Dobson, L., Kelly, J., Winyard, P. G., Jones, A. M., Benjamin, N., Shore, A. C., & Gilchrist, M. (2015) · Nitric Oxide · doi:10.1016/j.niox.2015.01.002 · Cited by 88
Aucouturier, J., Boissière, J., Pawlak-Chaouch, M., Cuvelier, G., & Gamelin, F.-X. (2015) · Nitric Oxide · doi:10.1016/j.niox.2015.05.004 · Cited by 85
Nahas, R. (2008) · PubMed Central · Cited by 68
On the mechanism by which dietary nitrate improves human skeletal muscle function
Affourtit, C., Bailey, S. J., Jones, A. M., Smallwood, M. J., & Winyard, P. G. (2015) · Frontiers in Physiology · doi:10.3389/fphys.2015.00211 · Cited by 58
Effects of chronic dietary nitrate supplementation on the hemodynamic response to dynamic exercise
Lee, J.-S., Stebbins, C. L., Jung, E., Nho, H., Kim, J.-K., Chang, M.-J., & Choi, H.-M. (2015) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00099.2015 · Cited by 56
Siervo, M., Lara, J., Jajja, A., Sutyarjoko, A., Ashor, A. W., Brandt, K., Qadir, O., Mathers, J. C., Benjamin, N., Winyard, P. G., et al. (2015) · Nitric Oxide · doi:10.1016/j.niox.2015.04.007 · Cited by 52
Bronsert, M. R., Henderson, W., Valuck, R., Hosokawa, P., & Hammermeister, K. (2013) · Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2013.05.130048 · Cited by 47
Lara, J., Ogbonmwan, I., Oggioni, C., Zheng, D., Qadir, O., Ashor, A. W., Brandt, K., Mathers, J. C., & Siervo, M. (2015) · Maturitas · doi:10.1016/j.maturitas.2015.07.028 · Cited by 44
Bailey, S. J., Blackwell, J. R., Wylie, L. J., Holland, T., Winyard, P. G., & JONES, A. M. (2016) · Nitric Oxide · doi:10.1016/j.niox.2016.10.002 · Cited by 39
Ashor, A. W., Jajja, A., Sutyarjoko, A., Brandt, K., Qadir, O., Lara, J., & Siervo, M. (2014) · Journal of Human Hypertension · doi:10.1038/jhh.2014.114 · Cited by 29
Kerley, C. P., Dolan, E., & Cormican, L. J. (2017) · Irish Journal of Medical Science (1971 -) · doi:10.1007/s11845-016-1551-2 · Cited by 25
Bailey, S. J., Blackwell, J. R., Wylie, L. J., Emery, A., Taylor, E., Winyard, P. G., & JONES, A. M. (2016) · Nitric Oxide · doi:10.1016/j.niox.2016.12.008 · Cited by 13
Research works printed but not linked: 2
- Singh, 2014, Chemical composition, functional properties and processing of beetroot—a review, Int J Sci Eng Res, 5, 679
- Aucouturier, 2015, Effect of dietary nitrate supplementation on tolerance to supramaximal intensity intermittent exercise, Nitric Oxide, 49, 16, 10.1016/j.niox.2015.05.004 · DOI · Paper page
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Valenzuela, P. L., Carrera‐Bastos, P., Gálvez, B. G., Ruiz‐Hurtado, G., Ordovás, J. M., Ruilope, L. M., & Lucía, A. (2020) · Nature Reviews Cardiology · doi:10.1038/s41569-020-00437-9 · Cited by 400
The oral microbiome in the pathophysiology of cardiovascular disease
Tonelli, A., Lumngwena, E. N., & Ntusi, N. (2023) · Nature Reviews Cardiology · doi:10.1038/s41569-022-00825-3 · Cited by 184
Grosso, G., Godos, J., Currenti, W., Micek, A., Falzone, L., Libra, M., Giampieri, F., Forbes-Hernández, T. Y., Quiles, J. L., Battino, M. A., et al. (2022) · Nutrients · doi:10.3390/nu14030545 · Cited by 174
Regulation of vascular tone homeostasis by NO and H2S: Implications in hypertension
Gheibi, S., Jeddi, S., Kashfi, K., & Ghasemi, A. (2018) · Biochemical Pharmacology · doi:10.1016/j.bcp.2018.01.017 · Cited by 121
Self-citationThe benefits and risks of beetroot juice consumption: a systematic review
Zamani, H., de Joode, M. E. J. R., Hossein, I. J., Henckens, N. F. T., Guggeis, M. A., Berends, J. E., de Kok, T. M. C. M., & van Breda, S. G. (2020) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2020.1746629 · Cited by 122
Metadata
- 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
- 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
- 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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