Dietary Nitrates and effect on Blood Pressure

Having recently completed a piece of research on hypertension, including a discussion on the extent to which integration of nutritional intervention is possible within a conventional medical program, findings show safe, novel and cost effective nutritional approaches that may standalone in the case of mild hypertension or in severe cases as an adjunct to conventional medicine.

What was really interesting for me was the extent to which a nutritional program can be integrated within a conventional medical treatment program for this condition, and in particular using the nitric oxide pathway.   Conventional medicine offers pharmacological intervention designed to affect the regulation of the renin-angiotensin-aldosterone system (RAAS) which regulates blood pressure and fluid balance.   Whilst anti-hypertensive drugs are the cornerstone in the management of hypertension associated with a reduction in strokes, heart attacks and heart failure, the evidence to support the role of diet and lifestyle in the management of hypertension is strong.

Hypertension is the medical term for blood pressure (BP) that is elevated beyond normal control affecting the cardiovascular, renal and central nervous systems.    Affecting more than a quarter of UK adults, this chronic inflammatory condition is commonly seen in a clinical setting that may be due to genetics, the result of a modern day lifestyle or other conditions.   Risk factors include a poor diet, a high intake of salt and alcohol, a high sodium to potassium ratio, obesity, smoking, a sedentary lifestyle, stress, advancing age, family history of high BP and gender related risk patterns.     Those with 20160520_090536high blood pressure, diabetes, high cholesterol levels, high triglyceride blood levels and kidney disease are at risk

Beyond the well-known effects of the DASH diet and the Mediterranean diet, numerous studies have investigated the possible blood pressure lowering effects with functional foods and nutraceuticals.     Evidence supports the use of peptides, beetroot juice, celery, garlic, probiotics, potassium, L-arginine, Vitamin C and D, cocoa flavonoids, controlled release of melatonin, aged garlic, coffee and green tea and may well prove useful as part of a nutritional strategy.

A recent controlled, randomised trial compared the use of inorganic
nitrate found in beetroot juice to a placebo for controlling blood pressure in hypertensive patients (Click here for link to paper).  Daily ingestion of beetroot juice consistently lowered blood pressure in hypertensive patients via bioconversion to the vasodilator nitric oxide by an amount comparable to single drug therapy.  No reduction was observed in those who took the placebo.  Additionally, the beetroot juice improved vascular and endothelial function with no adverse side effects.  The study shows durable blood pressure reduction from the nutritional intake of nitrates and an example of how nutrition has the potential for managing common chronic diseases, such as hypertension.  Daily consumption of beetroot juice and other vegetables high in nitrates including spinach, celery, lettuce, cress and chervil may reduce the incidence of hypertension and help when it exists, possibly reducing or eliminating the need for anti-hypertensive medications and improve cardiovascular risk.  This is especially important where medication may not be tolerated.   The dietary mechanism of the inorganic nitrate suggests approaches for other nutritional therapies are yet to be understood.


Kalpana Ratcliffe – Year 3 Nutritional Therapy Student

DISCLAIMER – this article is intended for information only and should not be considered to be nutritional advice. If you would like to change your diet please see a qualified registered practitioner for professional advice.


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