Abstract
According to current therapeutic approaches, a nitrate-dietary supplementation with beetroot juice (BRJ) is postulated as a nutritional strategy that might help to control arterial blood pressure in healthy subjects, pre-hypertensive population, and even patients diagnosed and treated with drugs. In this sense, a systematic review of random clinical trials (RCTs) published from 2008 to 2018 from PubMed/MEDLINE, ScienceDirect, and manual searches was conducted to identify studies examining the relationship between BRJ and blood pressure. The specific inclusion criteria were: (1) RCTs; (2) trials that assessed only the BRJ intake with control group; and (3) trials that reported the effects of this intervention on blood pressure. The search identified 11 studies that met the inclusion criteria. This review was able to demonstrate that BRJ supplementation is a cost-effective strategy that might reduce blood pressure in different populations, probably through the nitrate/nitrite/nitric oxide (NO3−/NO2−/NO) pathway and secondary metabolites found in Beta vulgaris. This easily found and cheap dietary intervention could significantly decrease the risk of suffering cardiovascular events and, in doing so, would help to diminish the mortality rate associated to this pathology. Hence, BRJ supplementation should be promoted as a key component of a healthy lifestyle to control blood pressure in healthy and hypertensive individuals. However, several factors related to BRJ intake (e.g., gender, secondary metabolites present in B. vulgaris, etc.) should be studied more deeply.
Highlights
Hypertension or high blood pressure (HBP) is a common disease that has become a pandemic for several years
Results from a total of 310 participants who were represented across the reviewed studies showed there is evidence suggesting that dietary supplementation with beetroot juice (BRJ) has a positive effect in reducing blood pressure, mainly on systolic blood pressure (SBP) compared to diastolic blood pressure (DBP)
On certain factors that probably modify this response are the characteristics of the intervened subjects themselves, and the type of intervention performed in the supplementation protocol (Table 1)
Summary
Hypertension or high blood pressure (HBP) is a common disease that has become a pandemic for several years. It has been stated that deficiency of some vitamins, such as folic acid, riboflavin, and vitamins C and D, can be considered risk factors to develop this non-communicable disease [4] Faced with this situation, scientific organizations, such as the American Heart Association (AHA), have recommended dietary approaches to stop hypertension (DASH), alongside the Mediterranean diet, as effective nutritional strategies included in the treatment of HBP [5]. The best-proven nonpharmacological interventions for the prevention and treatment of HBP, especially by means of the reduction of arterial systolic blood pressure (SBP), include weight loss, healthy diet, reduced intake of dietary sodium, enhanced intake of dietary potassium, physical activity, and moderation in alcohol intake. These inventions are able to reduce between 2 and 4 mmHg SBP, while in HBP there is a reduction between 4 and 11 mmHg SPB [6]
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