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Inorganic nitrate and beetroot juice supplementation reduces blood pressure in adults: systematic review and meta-analysis

Meta-analysis of 16 crossover RCTs (254 participants) finds inorganic nitrate or beetroot juice lowers pooled systolic BP by 4.4 mmHg with significant dose–response versus placebo; diastolic BP change −1.1 mmHg (95% CI includes 0; P=0.06).

Design

  • Included trials: 16 crossover RCTs, n = 254 (7–30 participants each), interventions 2 h to 15 days
  • Interventions: inorganic nitrate or beetroot juice vs placebo
  • Model: random-effects pooling

Pooled BP changes vs control

  • SBP: −4.4 mmHg (95% CI −5.9 to −2.8; P < 0.001)
  • DBP: −1.1 mmHg (95% CI −2.2 to +0.1; P = 0.06)
  • Meta-regression: association between daily nitrate dose and ΔSBP (P < 0.05)

Evidence hygiene

  • Mostly short crossover designs—acute/medium-term BP signals; long-term hard CV outcomes require separate trial streams.
  • Pairs with dietary nitrate (beetroot juice) (dietary-nitrate-supplementation) primary RCT corpus; do not merge with marine omega-3 lipid trials.

Publication

Siervo M, Lara J, Ogbonmwan I, Mathers JC. J Nutr. 2013 Jun;143(6):818-826. PMID 23596162.

Outcomes

  • Systolic Blood Pressure
    -4.4
    mmHg (Millimetres of Mercury)
  • Diastolic Blood Pressure
    -1.1
    mmHg (Millimetres of Mercury)
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