By Karen Kier, Pharmacist
On behalf of the ONU HealthWise team

In September of 1982, Billy Joel released his single titled Pressure. The song hit number 20 on the charts in the United States. The lyrics describe the pressure one applies when trying to write or create to support themselves. In Billy Joel’s career, he has been nominated for 23 Grammy Awards and has won 5. He was inducted into the Rock and Roll Hall of Fame in 1999 and received Kennedy Center Honors in 2013. 

Is there science behind using beets to help control blood pressure?

Beets, particularly beetroot juice, have gained attention as a natural approach to manage blood pressure. Beets contain a high concentration of nitrates, and when consumed in the diet, they are converted to nitrites. The nitrites are then made into nitric oxide, which is an important signaling molecule for proper heart function. Nitric oxide relaxes blood vessels, resulting in vasodilation. This relaxation of the blood vessels allows blood to flow more easily, reducing resistance and lowering blood pressure.

Nitric oxide improves the thin layer of cells lining the blood vessels known as the endothelium. A health of endothelium is essential for maintaining normal blood pressure and preventing heart disease. By increasing nitric oxide availability, beet-derived nitrates may help support this important physiological process.

What does the research tell us?

One of the earliest investigations focused on whether beetroot juice could produce measurable reductions in blood pressure shortly after consumption. A randomized, placebo-controlled trial published in 2012 examined healthy adults who consumed beetroot juice mixed with apple juice as part of their normal diet. The participants were given 250 mL (8.5 ounces) containing 500 grams (18 ounces) of beetroot from the commercially available juice. Researchers observed a 4-5mmHg reduction in systolic blood pressure (SBP) in male participants approximately six hours after drinking the juice, suggesting that dietary nitrates could have rapid heart effects. The normal SBP should be below 120mmHg. The beet juice would not normalize SBP in anyone with a pressure above 125mmHg. 

A meta-analysis, which combines data from multiple clinical trials, provides some additional evidence regarding the use of beetroot. The 2017 study evaluated 22 randomized clinical trials involving more than 1,200 participants. Researchers found that beetroot juice supplementation reduced SBP by an average of 3.55mmHg and diastolic blood pressure by 1.32mmHg compared with control groups. The analysis showed larger reductions in studies with longer durations and higher doses of beetroot juice. 

A 2024 meta-analysis reviewed 11 clinical trials involving 349 hypertensive patients. Researchers found that beetroot juice reduced SBP by approximately 5.31mmHg compared with placebo. The authors concluded that daily nitrate intake from beetroot juice may serve as a useful adjunct to conventional hypertension treatment, although they noted that overall evidence quality remains moderate to low and further large-scale studies are needed. 

The usual dose in the studies to see lower SBP was 500 grams of beetroot or 250 mL of beet juice. The dose can be achieved by eating 1-2 whole beets roasted and not boiled. The commercial chews on the market contain 500 milligrams per unit, indicating the need to chew an estimated 40 chews at one time to achieve a SBP lowering effect.  Capsules of beetroot powder are not recommended because the capsules bypass the conversion of the nitrates to nitrites in the mouth, and no nitric oxide is formed. 

Beetroot is not a cure for hypertension. Results vary between individuals, and factors such as age, baseline blood pressure, oral microbiome composition, medication use, and overall diet can influence effectiveness. 

Watch the labels of products because most only recommend supporting heart function and do not provide enough beetroot to be effective. Although these reductions may appear modest, even small decreases in blood pressure can be clinically meaningful. 

People taking blood pressure medications should consult a healthcare professional before significantly increasing beetroot intake, as additive blood pressure-lowering effects may occur. 

Beets may not beat the pressure enough to control blood pressure!