Nitrate Makes the Difference: How Beetroot Can Lower High Blood Pressure and Protect Blood Vessels
Laura Chrobok 23.09.2026
Beetroot is far more than just a colourful vegetable. One of its constituents in particular has attracted researchers’ attention for years: nitrate. Our bodies can convert it into nitric oxide — a substance that dilates blood vessels and can therefore also affect blood pressure.
What is behind this effect? We take a look at how nitrate from beetroot is processed in the body and what is known about its effects on blood vessels and circulation.
What Is Beetroot and What Makes It So Interesting to Researchers?
Beetroot (Beta vulgaris) is a cultivated form of beet and belongs to the amaranth family (Amaranthaceae). It is characterised by its thickened, usually deep-red root, which can be eaten raw or cooked as a vegetable and can also be made into juice (Royal Botanic Gardens, Kew).
Beetroot contains various vitamins, minerals and secondary plant compounds. However, research into blood pressure and vascular health focuses primarily on its inorganic nitrate content.
Even while beetroot is being chewed, bacteria in the mouth can convert some of its nitrate into nitrite. After swallowing, nitric oxide — or NO for short — can then be formed from it in the acidic environment of the stomach. It also passes into the bloodstream and tissues via the intestinal tract (Lidder & Webb, 2013).
Beetroot for Vascular Health and Lowering Blood Pressure
Nitric oxide performs important functions in the cardiovascular system. It acts on the smooth muscle of the blood vessels and can help them dilate, thereby reducing vascular resistance.
This is one of the mechanisms through which dietary nitrate can affect blood pressure.
In 2024, 11 randomised controlled trials involving a total of 349 patients were analysed to assess the effect of beetroot juice on high blood pressure.
For systolic blood pressure measured in a doctor’s surgery or clinic — i.e. the upper blood pressure reading — there was an average reduction of 5.31 mmHg compared with the control groups.
By contrast, no statistically significant effect was found for diastolic blood pressure, i.e. the lower reading. Nor was there a significant reduction in blood pressure measured over 24 hours (Grönroos et al., 2024).
The result is interesting, but needs to be viewed in a differentiated way: in this analysis, beetroot juice had a measurable effect on systolic blood pressure measured in a clinical setting, but not on all of the blood pressure parameters investigated. Research therefore provides evidence of a physiological effect. How pronounced this effect will be in an individual cannot be predicted.
But nitric oxide not only affects blood pressure; it also plays an important role in the function of the inner lining of the blood vessels — the endothelium.
A meta-analysis of randomised controlled trials investigated how inorganic nitrate and beetroot products affect blood vessel function. 12 studies involving a total of 246 participants were analysed. These included both studies in which vascular function was measured a few hours after a single dose and studies involving repeated intake for up to 28 days. The amounts and sources of nitrate used varied between studies. Overall, there was a significant improvement in the vascular function investigated compared with the control groups (Lara et al., 2016).
Beetroot Juice Is Also of Interest to Athletes
The effects of nitrate have made beetroot juice interesting in another field of research: sports.
Nitric oxide influences, among other things, blood flow and therefore the supply of oxygen and nutrients to tissues. Researchers are consequently also investigating whether beetroot juice can affect endurance and physical performance (Zamani et al., 2021).
The results are not the same for every person or every type of exercise. Nevertheless, sports science research provides another example of how the physiological effects of beetroot juice are being investigated far beyond its role as an ordinary food.
When Consuming Large Amounts of Beetroot Juice Can Be Risky
Beetroot is a healthy food. But, as is so often the case in life, “more is better” does not automatically apply. In larger quantities, nitrite can alter the red blood pigment haemoglobin in such a way that its ability to transport oxygen is impaired. In addition, under certain conditions, nitrite can form so-called N-nitroso compounds, some of which are carcinogenic. However, a systematic review of beetroot juice points out that the potential adverse effects of long-term high consumption have so far been studied far less extensively than its beneficial effects (Zamani et al., 2021).
Anyone who deliberately consumes beetroot juice regularly in large or highly concentrated amounts because of high blood pressure should therefore not assume that a higher nitrate dose automatically provides greater health benefits. Prescribed blood pressure treatment should not be altered or replaced without medical advice.
Beetroot: A Familiar “Superfood” That Deserves More Attention
Beetroot is not quite blood-red, but it can do a great deal for the health of our blood vessels … and more besides.
This root vegetable shows just how directly diet and vascular function can be connected. The body can convert the nitrate it contains into nitric oxide — a substance that acts directly on the blood vessels. What is particularly interesting is that this mechanism is also reflected in clinical studies: in people with high blood pressure, a measurable reduction in systolic blood pressure measured in a clinical setting has been observed.
It is an impressive example of how an everyday vegetable can have measurable physiological effects.
FAQ — Frequently Asked Questions About Beetroot and Its Effects on Heart Health
1. Is beetroot juice better than cooked beetroot?
This cannot be stated in general on the basis of the studies. The vegetable itself also contains nitrate. However, beetroot juice is frequently used in clinical studies because it allows a defined amount of nitrate to be administered and studied more precisely. Results from studies using standardised juice therefore cannot simply be transferred one-to-one to every portion of cooked beetroot.
2. How much beetroot juice do I need to drink to lower my blood pressure?
The study findings do not allow a general dosage recommendation for the self-treatment of high blood pressure.
3. How quickly does beetroot juice affect blood pressure?
The nitrate-nitrite-nitric oxide pathway begins after ingestion. Studies have investigated both short-term and longer-term effects. However, they do not provide a fixed period of time after which beetroot juice will lower blood pressure in every individual (Lidder & Webb, 2013).
4. Can mouthwash affect the effects of beetroot?
Yes, at least certain antibacterial mouthwashes can play a role. They inhibit bacteria in the mouth that convert nitrate from beetroot into nitrite. As a result, less nitrite can be produced and subsequently less nitric oxide can be formed. Because nitric oxide contributes to the dilation of blood vessels, this metabolic pathway, which is important for beetroot’s potential effect on blood pressure, can be weakened. However, it has not yet been conclusively established whether the regular use of such mouthwashes actually results in higher blood pressure in affected individuals over the long term (Govoni et al., 2008).
Further information on cardiovascular health — and, of course, many other topics — can be found on our blog, in our “Medizinskandale” book series and in the “Codex Humanus”, the fifth volume of which was recently published. We look forward to welcoming you to our online shop.
Sources:
· Royal Botanic Gardens, Kew: “Beta vulgaris L.,” Plants of the World Online.
· Lidder, S.; Webb, A. J. (2013): “Vascular Effects of Dietary Nitrate (as Found in Green Leafy Vegetables and Beetroot) via the Nitrate-Nitrite-Nitric Oxide Pathway,” British Journal of Clinical Pharmacology.
· Grönroos, R. et al. (2024): “Effects of Beetroot Juice on Blood Pressure in Hypertension According to European Society of Hypertension Guidelines: A Systematic Review and Meta-Analysis,” Nutrition, Metabolism and Cardiovascular Diseases.
· Lara, J. et al. (2016): “Effects of Inorganic Nitrate and Beetroot Supplementation on Endothelial Function: A Systematic Review and Meta-Analysis,” European Journal of Nutrition.
· Zamani, H. et al. (2021): “The Benefits and Risks of Beetroot Juice Consumption: A Systematic Review,” Critical Reviews in Food Science and Nutrition.
· The Increase in Plasma Nitrite After a Dietary Nitrate Load Is Markedly Attenuated by an Antibacterial Mouthwash,” Nitric Oxide.
· · Govoni, M. et al. (2008): “The Increase in Plasma Nitrite After a Dietary Nitrate Load Is Markedly Attenuated by an Antibacterial Mouthwash,” Nitric Oxide.
· · The Increase in Plasma Nitrite After a Dietary Nitrate Load Is Markedly Attenuated by an Antibacterial Mouthwash,” Nitric Oxide.