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6 Dietary nitrate also has additional benefits on platelets, endothelial function and mitochondrial efficiency. 3- 5 Furthermore, independent of peripheral BP, in hypertensive patients with or at risk of diabetes mellitus, chronic treatment with beetroot juice over 6 months results in beneficial changes in cardiac chamber volume. Beetroot juice has been shown to produce beneficial cardiovascular effects, 1 decreasing blood pressure (BP) in both healthy volunteers 2 and in patients with hypertension. The haemodynamic mechanisms are unclear but may involve a synergistic dynamic effect and/or the production of nitric oxide species other than nitrite.ĭietary inorganic nitrate (NO 3 −) is found in beetroot and green leafy vegetables.Grapefruit juice potentiated the systolic blood pressure-lowering effect of beetroot juice, despite decreasing plasma and salivary nitrite production.Besides suggesting more complex mechanisms, there is potential for maximising the clinical benefit of dietary nitrate and targeting isolated systolic hypertension. Grapefruit juice enhanced beetroot juice's effect on lowering SBP and PP despite decreasing plasma. The taste score of Beet+GFJ was 1.4/10 points higher than Beet+H 2O ( P =. 006), as was salivary nitrite production ( P =. Contrary to the hypothesis, plasma was lower with Active Beet+GFJ vs Active Beet+H 2O ( P =. Peak mean differences in SBP and PP were seen at T = 5 hours: −3.3 mmHg (95% confidence interval −6.43 to −0.15) and at T = 2.5 hours: −4.2 mmHg (95% CI −0.3 to −8.2), respectively. The addition of grapefruit juice to active beetroot juice lowered systolic BP (SBP): Active Beet+GFJ vs Active Beet+H 2O ( P =. We performed a randomized, placebo-controlled, 7-hour crossover study in 11 healthy volunteers, attending on 3 occasions, receiving: a 70-mL shot of active beetroot juice (Beet-It) and either (i) 250 mL grapefruit juice (Active Beet+GFJ), or (ii) 250 mL water (Buxton, Active Beet+H 2O) or (iii) Placebo Beet+GFJ. We therefore hypothesized that grapefruit juice would enhance BP-lowering with beetroot juice by maintaining circulating. Grapefruit juice contains the CYP3A4 inhibitor furanocoumarin. Cytochrome P450-3A4 inhibition with troleandomycin prevents nitrite re-oxidation to nitrate in rodent liver. However, NO and nitrite are inactivated via reoxidation to nitrate, potentially limiting their activity. Dietary nitrate from sources such as beetroot juice lowers blood pressure (BP) via the nitrate–nitrite–nitric oxide (NO) pathway.
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