randyf
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Significant decrease in BP with beet juice.
Seems inorganic nitrate (NO3) is responsible.
Randy
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Beet Juice Beats Hypertension
By Nancy Walsh, Staff Writer, MedPage Today
Published: April 15, 2013
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of
Medicine, University of California, San Francisco and Dorothy Caputo,
MA, BSN, RN, Nurse Planner
Drinking a cup of nitrate-rich beetroot juice significantly lowered
blood pressure (BP) in hypertensive individuals.
Note that the study participants tolerated the regimen well.
Drinking a cup of nitrate-rich beetroot juice significantly lowered
blood pressure (BP) in hypertensive individuals, a small, proof-of-
principle study showed.
Three to 6 hours after a single dose of 250 mL of beetroot juice,
systolic BP decreased by a mean 11.2 mm Hg in patients with
hypertension compared with a decrease of 0.7 mm Hg in controls,
according to Amrita Ahluwalia, PhD, of Queen Mary University of
London, and colleagues.
At 24 hours, systolic BP remained significantly lower in the treatment
group compared with controls, with a difference of 8.5 mm Hg (P<0.01),
the researchers reported in Hypertension: Journal of the American
Heart Association.
Recent studies have suggested that the health benefits of fruits and
vegetables in the diet may derive from the presence of inorganic
nitrate (NO3), which is found in particularly high levels in beetroot
and leafy vegetables.
Following consumption, NO3 is bioactivated by conversion to inorganic
nitrite (NO2), which in turn is reduced to nitric oxide (NO) through
various pathways, resulting in vasodilation.
In experiments conducted in both animals and healthy volunteers, high
doses of nitrite lowered BP, but neither the specific enzymatic
process nor its precise location -- in the vessel wall or the
erythrocyte -- has been identified.
To expand the understanding of the physiologic effects of nitrite,
Ahluwalia's group first conducted a series of experiments comparing
the effects of nitrite administration in hypertensive and normotensive
rats. They determined the reductase pathway responsible for nitrite
conversion involved xanthine oxidoreductase (XOR) and established the
erythrocyte as the site of nitrite reduction in hypertension.
In addition, the administration of allopurinol blocked these effects
in the hypertensive animals, but had no effect in the normotensive
animals.
The subsequent proof-of-principle study included 15 participants with
BPs above 140/90 who had not previously received antihypertensive
therapy.
The group consisted of eight women and seven men whose mean age was 53
and who received a relatively low (13.2 × 10-3 mol/L) dose of nitrite
in beetroot juice or an equivalent amount of water containing nitrite
levels of 0.07 × 10-3 mol/L.
The dose of nitrite in the beetroot group had previously shown little
effect on BP in healthy volunteers, the researchers noted.
Significant decreases in both systolic and diastolic BPs occurred in
participants receiving beetroot juice compared with controls
(P<0.001), with diastolic pressures showing a peak lowering of 9.6 mm
Hg.
Pulse wave velocity also fell significantly (P<0.05) in those
receiving the juice.
Changes in systolic BP correlated with change in plasma nitrite levels
(r=0.280, P<0.001), and decreases correlated with baseline systolic BP
(r=0.561, P<0.05).
As with the animal studies, the erythrocyte was the site of
bioactivity, with high levels of XOR expression and inhibition by
allopurinol being observed.
In discussing their findings, the researchers noted that circulating
levels of nitrate and nitrite had returned to normal 24 hours after
administration, yet BP reductions persisted.
"It is possible that while circulating nitrite levels have diminished,
tissue levels remain elevated providing a continued supply of NO,
although further mechanistic studies exploring this possibility are
warranted," they wrote.
The study demonstrated that BP lowering occurs with nitrite
administration most strongly in hypertensive animals and humans and
could represent a therapeutic option, they concluded.
The study participants tolerated the regimen well.
"This is a natural compound, and is quite innocuous," said William
O'Neill, MD, of Henry Ford Hospital in Detroit, who was not involved
in the study.
But O'Neill cautioned against the use of beetroot juice by patients
with renal failure.
"I'm not sure what's going to happen to potassium levels in the
bloodstream if they have renal insufficiency," he told MedPage Today.
"Given that approximately 50% of treated hypertensive subjects fail to
achieve their target BP, an additional strategy, based on intake of
nitrate-rich vegetables, may prove to be cost-effective, easily
achievable, safe, and favorable for public health," they noted.
A limitation of the study was its short duration, and further work
will be needed to determine if long-term dietary increases in nitrite-
containing foods can lead to sustained BP lowering.