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Editorial

Beetroot Juice May Be a Dietary Ingredient to Protect Vascular Endothelium

The first Dietary Recommendations originated in 1941 by order of President Franklin Roosevelt, when he convened the “National Conference on Nutrition in Defense” to guarantee a population fit for war, minimizing diseases due to deficiency of nutrients.In the same year, the American Medical Association declared that “nutrition research should be encouraged” with primary objectives of “estimating the amounts of essential nutrients in foods,” “detection of nutritional deficiency states,” and more precise determination of “optimal and minimum requirements” for each nutrient.

In humans, after absorption through the stomach wall, 25% of the nitrate consumed enters the entero-salivary circulation, where it is reduced to nitrite (NO₂) by bacterial nitrate reductases of facultative anaerobes on the dorsal surface of the tongue.^,This nitrite is swallowed and, in the stomach’s acidic environment, is reduced to nitric oxide (NO) or re-enters the circulation as nitrite. Thus, dietary nitrate may represent an intravascular source of the pleiotropic vasoprotective molecule NO and acts as a potent dilator of blood pressure and delays atherogenesis by inhibiting the recruitment of inflammatory cells and platelet aggregation. Thus, protecting the vascular endothelium influences numerous cardiovascular pathologies (prehypertension, hypertension, atherosclerosis, and stroke) associated with endothelial dysfunction and decreased NObioactivity. Recently, studies have shown that nitrite confers marked protection against ischemia/reperfusion (I/R) injury to the myocardium, kidney, lung, and cerebral vasculature.^,

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Original Article

Acute Effects of Dietary Nitrate on Central Pressure and Endothelial Function in Hypertensive Patients: A Randomized, Placebo-Controlled Crossover Study

Samanta Mattos et al. Michelle Rabello Cunha Bianca Cristina Marques Jenifer d´El-Rei … Diego dos Santos Baião Vania M. F. Paschoalin Wille Oigman Mario Fritsch Neves Fernanda Medeiros

Abstract

Background

The diet’s inorganic nitrate (NO₃^–) may provide a physiological substrate for reducing nitrate (NO₂^–) to NO independent of the endothelium. Studies suggest that inorganic NO₃^– has beneficial effects on cardiovascular health.

Objective

This study evaluated the acute effects of 500 mL nitrate-rich beetroot juice (BRJ; containing 11.5mmol NO₃^–) on blood pressure and endothelial function in treated hypertensive patients.

Methods

A randomized, placebo-controlled, crossover study was conducted in treated hypertensive patients (n=37; women=62%) who underwent clinical and nutritional evaluation and assessment of central hemodynamic parameters and microvascular reactivity. The significance level was p<0.05.

Results

The mean age was 59±7 years, and mean systolic and diastolic blood pressures were 142±10/83±9mmHg. There was a significant increase in the subendocardial viability ratio (SEVR; 149±25 vs. 165±30%, p<0.001) and reduction in ejection duration (ED; 37±4 vs. 34±4%, p<0.001) in the beetroot phase but no significant SEVR difference in the control phase. The % increase in perfusion (155 vs. 159 %, p=0.042) was significantly increased in the beetroot phase, which was not observed in the control phase. In the beetroot phase, the change in SEVR showed a significant correlation with the change in the area under the curve of post-occlusive reactive hyperemia (AUC-PORH) (r=0.45, p=0.012). The change in ED showed a significant correlation with the post-intervention perfusion peak (r=-0.37, p=0.031) and AUC-PORH (r=-0.36, p=0.046).

Conclusions

The acute ingestion of BRJ by hypertensive patients resulted in an improvement of endothelial function, which was associated with higher subendocardial viability and performance in myocardial contraction.