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Medium-term effects of dietary nitrate supplementation on systolic and diastolic blood pressure in adults: a systematic review and meta-analysis

Lookup NU author(s): Ammar Ashor, Dr Mario Siervo


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Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved. OBJECTIVES:: Dietary nitrate supplementation has been shown to lower blood pressure (BP) particularly in short-term clinical trials. Whether these effects are sustained in the long-term remains to be established. The objective was to conduct a meta-analysis of randomized controlled trials that examined whether dietary nitrate supplementation for more than 1 week has beneficial effects on SBP and DBP. METHODS:: Electronic databases were searched from inception until May 2016. Specific inclusion criteria were duration at least 1 week, report of effects on SBP or DBP or both and comparison of inorganic nitrate or beetroot juice supplementation with placebo control groups. Random-effects models were used to calculate the pooled BP effect sizes. RESULTS:: Thirteen trials met eligibility criteria. The trials included a total of 325 participants with seven to 65 participants per study. The duration of each intervention ranged from 1 to 6 weeks. Ten trials assessed BP in resting clinic conditions, whereas 24-h ambulatory and daily home monitorings were used in six and three trials, respectively. Overall, dietary nitrate was associated with a significant decline in SBP [−4.1?mmHg (95% confidence interval: −6.1, −2.2); P?<?0.001] and DBP [−2.0?mmHg (95% confidence interval: −3.0, −0.9); P?<?0.001]. However, the effect was only significant when measured in resting clinical settings as no significant changes in BP were observed using 24-h ambulatory and daily home BP monitorings. CONCLUSION:: Positive effects of medium-term dietary nitrate supplementation on BP were only observed in clinical settings, which were not corroborated by more accurate methods such as 24-h ambulatory and daily home monitorings.

Publication metadata

Author(s): Ashor AW, Lara J, Siervo M

Publication type: Article

Publication status: Published

Journal: Journal of Hypertension

Year: 2017

Volume: 35

Issue: 7

Pages: 1353-1359

Print publication date: 01/07/2017

Online publication date: 17/03/2017

Acceptance date: 02/04/2016

ISSN (print): 0263-6352

ISSN (electronic): 1473-5598

Publisher: Lippincott Williams and Wilkins


DOI: 10.1097/HJH.0000000000001305


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