What is the science behind using beets to manage hypertension?

From the Guidelines

Beets can help manage hypertension primarily through their high nitrate content, which the body converts to nitric oxide, a compound that relaxes blood vessels and improves blood flow, as supported by the 2020 international society of hypertension global hypertension practice guidelines 1. When consumed regularly, beetroot juice or whole beets may lower blood pressure by 3-10 mmHg in many individuals. A typical effective regimen involves drinking about 250ml (8oz) of beetroot juice daily or consuming 1-2 medium beets (about 100-200g). The blood pressure-lowering effect typically begins within 3 hours of consumption and may last up to 24 hours, with more sustained benefits seen with regular intake over weeks. The nitrates in beets are converted to nitrite by bacteria in the mouth and then to nitric oxide in the stomach and bloodstream. This nitric oxide helps dilate blood vessels, reducing peripheral resistance and thus lowering blood pressure. For best results, avoid using antibacterial mouthwash before consuming beets, as this can kill the beneficial bacteria needed for nitrate conversion. While generally safe, people taking medications for erectile dysfunction or nitrate medications for heart conditions should consult their doctor before using beets as a blood pressure remedy due to potential additive effects.

Some key points to consider when using beets to manage hypertension include:

• Increasing intake of vegetables high in nitrates, such as leafy vegetables and beetroot, as recommended by the 2020 international society of hypertension global hypertension practice guidelines 1
• Drinking beetroot juice or consuming whole beets regularly to lower blood pressure
• Avoiding antibacterial mouthwash before consuming beets to preserve the beneficial bacteria needed for nitrate conversion
• Consulting a doctor before using beets as a blood pressure remedy, especially for individuals taking medications for erectile dysfunction or nitrate medications for heart conditions

It's also important to note that beets are just one part of a comprehensive approach to managing hypertension, and should be used in conjunction with other lifestyle modifications, such as:

• Reducing salt intake and consuming a healthy diet, as recommended by the 2020 international society of hypertension global hypertension practice guidelines 1
• Engaging in regular physical activity, such as walking or jogging, as recommended by the 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk 1
• Maintaining a healthy weight and body mass index, as recommended by the seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure 1

From the Research

Science Behind Beets and Blood Pressure

The relationship between beets and blood pressure has been extensively studied, with a focus on the potential of beetroot juice to lower blood pressure in individuals with hypertension.

• Beetroot juice is rich in dietary nitrate, which is converted to nitric oxide in the body, a potent vasodilator that can help to relax and widen blood vessels, thereby reducing blood pressure 2, 3.
• Studies have shown that daily supplementation with beetroot juice can reduce blood pressure in healthy individuals and those with hypertension, with reductions in systolic blood pressure ranging from 4-8 mmHg 3, 4, 5.
• The exact mechanisms by which beetroot juice lowers blood pressure are not fully understood, but it is thought to involve the nitrate/nitrite/nitric oxide pathway, as well as other secondary metabolites found in beetroot 2.
• In addition to its potential to lower blood pressure, beetroot juice has also been shown to improve endothelial function and reduce arterial stiffness, both of which are important markers of cardiovascular health 3.

Key Findings

• A systematic review of 11 randomized controlled trials found that beetroot juice supplementation was associated with significant reductions in systolic blood pressure, with a mean reduction of 5.31 mmHg 4.
• A randomized, double-blind, placebo-controlled trial found that daily supplementation with beetroot juice for 4 weeks reduced blood pressure in patients with hypertension, with mean reductions of 7.7/2.4 mmHg in clinic blood pressure and 7.7/5.2 mmHg in 24-hour ambulatory blood pressure 3.
• A meta-analysis of 11 randomized controlled trials found that beetroot juice supplementation was associated with significant reductions in clinical systolic blood pressure, with a mean reduction of 5.31 mmHg 4.

Potential Benefits and Limitations

• The potential benefits of using beetroot juice to manage hypertension include its ease of use, low cost, and potential to reduce the risk of cardiovascular events 2, 3.
• However, the evidence is not yet conclusive, and more research is needed to fully understand the effects of beetroot juice on blood pressure and cardiovascular health 4, 6.
• Additionally, individual results may vary, and beetroot juice may not be effective for everyone, particularly those with certain medical conditions or taking certain medications 5.