Dataset Information

Nitrate Derived From Beetroot Juice Lowers Blood Pressure in Patients With Arterial Hypertension: A Systematic Review and Meta-Analysis.

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.

SUBMITTER: Benjamim CJR

PROVIDER: S-EPMC8965354 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

Nitrate Derived From Beetroot Juice Lowers Blood Pressure in Patients With Arterial Hypertension: A Systematic Review and Meta-Analysis.

Benjamim Cicero Jonas R CJR Porto Andrey Alves AA Valenti Vitor Engrácia VE Sobrinho Andressa Crystine da Silva ACDS Garner David M DM Gualano Bruno B Bueno Júnior Carlos Roberto CR

Frontiers in nutrition 20220315

<h4>Background</h4>Although there are a considerable number of clinical studies on nitrate (NO<sub>3</sub>) rich beetroot juice (BRJ) and hypertension, it is difficult to indicate the real effects of NO<sub>3</sub> from BRJ on the BP of hypertensive patients because there are still no estimates of the effects of NO<sub>3</sub> derived from BRJ on the BP of hypertension patients.<h4>Objective</h4>To clarify these effects, we developed a systematic literature review with a meta-analysis of randomi ...[more]

PMID: 35369064

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Project description:BackgroundIn Sub-Saharan Africa, current strategies are struggling to control the burgeoning hypertension epidemic. Dietary interventions such as inorganic nitrate or folic acid supplementation could represent promising strategies for reducing blood pressure (BP) in this setting.ObjectivesThis feasibility study explores the effects of dietary inorganic nitrate supplementation, alone or in combination with folic acid, on BP in Tanzanian adults with elevated BP in Tanzania.MethodsA placebo-controlled, double-blind, randomized controlled feasibility trial was conducted. Forty-seven middle-aged and older participants (age: 50-70 y, BMI: 26.3-29.1 kg/m2) were randomly assigned to 3 conditions for a period of 60 d: 1) high-nitrate beetroot juice (∼400 mg nitrate) and folic acid (∼5 mg folic acid) (N + F), 2) high-nitrate beetroot juice and placebo (N + P), or 3) nitrate-depleted beetroot juice and placebo (P + P). Clinic and 24-h ambulatory BP and measurements of compliance in plasma (nitrate and folate concentrations) and saliva (nitrate and nitrite) were obtained at baseline, 30 d, and 60 d.ResultsBaseline resting systolic and diastolic BP (mean ± SD) was 151.0 ± 19.4 mm Hg and 91.8 ± 11.7 mm Hg, respectively. Compliance to the interventions was high (>90%) in all groups which was confirmed by the significant increase in nitrate and folic acid concentrations in plasma and saliva samples in the treatment arms. After 60 d, 24-h systolic BP dropped by -10.8 ± 9.8 mm Hg (P < 0.001), -6.1 ± 13.2 mm Hg (P = 0.03), and -0.3 ± 9.7 mm Hg (P = 0.83) in the N + P, N + F, and P + P groups, respectively. There was a significant decrease in 24-h diastolic BP in the N + P group (-5.4 ± 5.0 mm Hg, P = 0.004), whereas changes were not significant in the N + F (-1.8 ± 8.1 mm Hg, P = 0.32) and P + P (1.6 ± 8.3 mm Hg, P = 0.43) groups.ConclusionsDietary inorganic nitrate represents a potential nutritional strategy to lessen the hypertension epidemic in Sub-Saharan Africa. These findings support the rationale for future long-term investigations exploring the efficacy of dietary nitrate for lowering BP and attenuating cardiovascular disease risk in this setting.This trial was registered at isrctn.com as ISRCTN67978523.

Project description:BackgroundAlthough transplantation of the fecal microbiota from normotensive donors has been shown to have an antihypertensive effect in hypertensive animal models, its effect on blood pressure in patients with hypertension is unclear. This study aimed to assess the effect of washed microbiota transplantation (WMT) from normotensive donors on blood pressure regulation in hypertensive patients.MethodsThe clinical data of consecutive patients treated with washed microbiota transplantation (WMT) were collected retrospectively. The blood pressures of hypertensive patients before and after WMT were compared. The factors influencing the antihypertensive effect of WMT in hypertensive patients and fecal microbial composition of donors and hypertensive patients were also analyzed.ResultsWMT exhibited an antihypertensive effect on blood pressure: the blood pressure at hospital discharge was significantly lower than that at hospital admission (change in systolic blood pressure: -5.09 ± 15.51, P = 0.009; change in diastolic blood pressure: -7.74 ± 10.42, P < 0.001). Hypertensive patients who underwent WMT via the lower gastrointestinal tract (β = -8.308, standard error = 3.856, P = 0.036) and those not taking antihypertensive drugs (β = -8.969, standard error = 4.256, P = 0.040) had a greater decrease in systolic blood pressure, and hypertensive patients not taking antihypertensive drugs also had a greater decrease in diastolic blood pressure (β = -8.637, standard error = 2.861, P = 0.004). After WMT, the Shannon Diversity Index was higher in six of eight hypertensive patients and the microbial composition of post-WMT samples tended to be closer to that of donor samples.ConclusionWMT had a blood pressure-lowering effect in hypertensive patients, especially in those who underwent WMT via the lower gastrointestinal tract and in those not taking antihypertensive drugs. Therefore, modulation of the gut microbiota by WMT may offer a novel approach for hypertension treatment.

Dataset Information

Nitrate Derived From Beetroot Juice Lowers Blood Pressure in Patients With Arterial Hypertension: A Systematic Review and Meta-Analysis.

Background

Objective

Design

Results

Conclusions

Systematic review registration

Publications

Nitrate Derived From Beetroot Juice Lowers Blood Pressure in Patients With Arterial Hypertension: A Systematic Review and Meta-Analysis.

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