Nitrate-rich beetroot juice selectively lowers ambulatory pressures and LDL cholesterol in uncontrolled but not controlled hypertension: a pilot study



Dietary nitrate has been shown to increase nitrate/nitrite levels in multiple populations, with potential blood pressure lowering effects. However, there are few reports among hypertensives.


We aimed to assess the effect of daily nitrate in subjects with controlled hypertension vs. uncontrolled hypertension.


On day 0, hypertensives wore an ambulatory BP monitor (ABPM) for 24 h and fasting blood was taken. Subjects then consumed concentrated beetroot juice (12.9 mmol nitrate) for 14 consecutive days. On day 14 subjects consumed their last nitrate dose after fasting blood was drawn and again had an ABPM for 24 h.


According to baseline ABPM, 11 subjects had controlled BP while 8 had uncontrolled BP. There were similar, significant increases in serum nitrate/nitrite in both groups. We observed little change in BP variables among controlled hypertensives. However, there were reductions in BP variables in uncontrolled hypertensives where decreases in nighttime DBP (−6 ± 4.8 mmHg), arterial stiffness (−0.08 ± 0.03 ambulatory arterial stiffness index) and LDL (−0.36 ± 0.42 mmol/L) reached significance (p = 003, 0.05 and 0.046, respectively).


Our results support the existing data suggesting an anti-hypertensive effect of nitrate-containing beetroot juice, but only among those with uncontrolled hypertension.

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Ambulatory arterial stiffness index


Ambulatory blood pressure


Body mass index


Blood pressure


Beetroot juice


Flow mediated dilation




Nitric oxide


Nitric oxide synthase


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This work was funded by the Irish Heart Foundation. The authors also wish to acknowledge Dr. Jamie Blackwell (BSc) of the University of Exeter, who analyzed serum samples for nitrate and nitrite.

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Correspondence to C. P. Kerley.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Kerley, C.P., Dolan, E. & Cormican, L. Nitrate-rich beetroot juice selectively lowers ambulatory pressures and LDL cholesterol in uncontrolled but not controlled hypertension: a pilot study. Ir J Med Sci 186, 895–902 (2017).

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  • Dietary nitrate
  • Nitrite
  • Nitric oxide
  • Hypertension
  • Blood pressure