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meta analysis1,551 participants

Beetroot Supplementation and Blood Pressure: 2023 Meta-Analysis of 22 RCTs

DJP
Reviewed by , MD, Board Certified Internal Medicine

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TL;DR — Quick Answer

A meta-analysis of 22 RCTs (n=1,551) found that beetroot supplementation significantly reduced systolic blood pressure by 3.55 mmHg and diastolic blood pressure by 1.32 mmHg. Effects were mediated through dietary nitrate conversion to nitric oxide, which promotes vasodilation. Benefits were dose-dependent and more pronounced with supplementation lasting 2+ weeks.

Key Findings

  • Beetroot supplementation reduced systolic blood pressure by a weighted mean of 3.55 mmHg (95% CI: -4.55 to -2.54, p < 0.001) across 22 RCTs
  • Diastolic blood pressure decreased by 1.32 mmHg (95% CI: -1.97 to -0.68, p < 0.001), with effects most consistent in hypertensive and prehypertensive populations
  • The mechanism operates through the nitrate-nitrite-nitric oxide pathway: dietary nitrate from beetroot is converted to nitrite by oral bacteria, then to nitric oxide in the vasculature, promoting vasodilation and reducing peripheral resistance
  • Dose-response analysis found that 300-500mg of dietary nitrate daily (equivalent to ~250-500mL beetroot juice or 500-1000mg beetroot powder extract) produced optimal blood pressure reduction, with diminishing returns above 500mg
  • Chronic supplementation (14+ days) produced greater and more sustained blood pressure reduction compared to acute single-dose studies, suggesting cumulative vascular remodeling benefits

Study Details

Effects of dietary nitrate on blood pressure: a systematic review and meta-analysis
Siervo M, Lara J, Ogbonmwan I, Mathers JC — Hypertension (2013)
Inorganic nitrate supplementation reduced systolic BP by 4.4 mmHg across 16 trials; beetroot juice was the most common delivery vehicle
254 participantsHigh
Dietary nitrate from beetroot juice for hypertension: a systematic review
Bonilla Ocampo DA, Paipilla AF, Marin E, Vargas-Molina S, Petro JL, Perez-Idarraga A — Biomolecules (2018)
Systematic review confirming beetroot juice as an effective dietary strategy for blood pressure reduction via nitric oxide pathway; noted dose-dependency and importance of chronic supplementation
0 participantsModerate

Practical Takeaway

For blood pressure support, daily beetroot supplementation providing 300-500mg dietary nitrate (about 250mL beetroot juice or a standard beetroot powder serving) for at least 2 weeks is well-supported. The 3.55 mmHg systolic reduction is clinically meaningful — population-level data suggests a 2 mmHg reduction in systolic BP reduces stroke mortality by 10%. Do not use antiseptic mouthwash immediately before or after beetroot supplementation, as it kills the oral bacteria needed for nitrate-to-nitrite conversion.

Summary

A meta-analysis of 22 randomized controlled trials examining the effects of beetroot (Beta vulgaris) supplementation on blood pressure via nitric oxide pathway activation, involving 1,551 participants.

Related Supplements

Beet Root

References

  1. (). Inorganic nitrate and beetroot juice supplementation reduces blood pressure in adults: a systematic review and meta-analysis. Journal of Nutrition. DOI
  2. (). Dietary nitrate from beetroot juice for hypertension: a systematic review. Biomolecules. DOI
  3. (). Dietary nitrate provides sustained blood pressure lowering in hypertensive patients: a randomized, phase 2, double-blind, placebo-controlled study. Hypertension. DOI