Beetroot for Blood Pressure: What the Evidence Really Shows
Educational summary — not medical advice. Beetroot is an adjunct, not a replacement for prescribed blood-pressure treatment. Talk to your clinician before combining it with medication.
The honest answer
Beetroot lowers blood pressure modestly and real: a meta-analysis of 22 studies found systolic ~−3.9 mmHg (diastolic ~−2.6), biggest in people who are ≥65, obese, or prehypertensive (He 2021). But durability is limited — a separate 2024 analysis saw the effect only up to ~90 days and none on 24-hour ambulatory pressure (2024). It works via nitrate → nitric oxide. Two cautions matter: oxalate/kidney stones and additive BP-lowering with meds.
The mechanism is real
Beetroot is one of the richest dietary sources of inorganic nitrate. Swallowed nitrate is reduced by oral bacteria to nitrite, then to nitric oxide, which relaxes the smooth muscle in blood-vessel walls and lowers pressure (the nitrate → nitrite → nitric oxide pathway, Lundberg 2008). This is a genuine physiological route, not a marketing story — which is why beetroot has more blood-pressure evidence behind it than most "heart health" supplements. The catch, covered on the label-trap page, is that you usually can't tell how much nitrate a given product actually delivers.
What the trials show — and where they stop
Two separate meta-analyses tell a consistent but appropriately humble story. Keep them distinct — they are two different papers:
| Study | Population | Finding | The honest limit |
|---|---|---|---|
| He 2021 PMID 33905826 | Meta-analysis, 22 studies (older adults) | Systolic −3.90 mmHg (95% CI −5.23 to −2.57); diastolic −2.62 mmHg | Greatest effect if ≥65, BMI >30, or prehypertensive — smaller otherwise |
| 2024 durability analysis PMID 39117485 | 11 trials, 349 people with hypertension | Clinic systolic −5.31 mmHg | Significant only up to ~90 days; no significant 24-h ambulatory reduction; no diastolic effect |
Read together: the office-measured drop is real and clinically meaningful-ish (a few mmHg matters at population scale), but it may not persist long-term and may not show on around-the-clock monitoring. That's why the fair framing is a short-to-medium-term adjunct — useful alongside diet, exercise, and any prescribed treatment, not a standalone fix. And it only works if you actually get a nitrate dose (~6 mmol/day and up), which most products don't disclose.
Who it's most reasonable for
- Older adults, or people with prehypertension or obesity — where the effect was largest (He 2021).
- As an adjunct to diet, exercise, and any prescribed medication — not a replacement, and not a reason to change a prescription without your doctor.
- People who'll actually dose the nitrate — aim for a disclosed ~6 mmol/day (~372 mg); most products can't confirm this, so favor one that discloses nitrate (the comparison).
Skip or get medical advice first if you: form calcium-oxalate kidney stones; take a PDE5 inhibitor or blood-pressure medication (additive lowering); or have low blood pressure already.
Frequently asked questions
Does beetroot lower blood pressure?
Modestly — systolic ~−3.9 mmHg, diastolic ~−2.6 (meta-analysis of 22 studies), biggest in people ≥65, obese, or prehypertensive (He 2021). A small adjunct effect, not a medication replacement.
How long does the effect last?
Uncertain. A 2024 analysis of 11 hypertension trials found clinic systolic −5.3 mmHg but significant only up to ~90 days, with no effect on 24-h ambulatory BP and no diastolic effect (PMID 39117485). Best seen as short-to-medium-term.
Can I take it with BP meds or Viagra?
Ask your doctor. Dietary nitrate isn't the nitroglycerin that's contraindicated with PDE5 inhibitors (Schwartz & Kloner 2010; Kloner 2018) — the real concern is additive blood-pressure lowering when stacked with a PDE5 inhibitor or antihypertensive.
Is it safe if I get kidney stones?
Be cautious if you form calcium-oxalate stones — beets are high in oxalate (~60–70 mg/100 mL juice) and raise urinary oxalate (Massey 1993). Discuss concentrated beetroot with your clinician first.
Related
- Beetroot: what it is & who it's for
- Beetroot dosage guide — the ~6–13 mmol nitrate dose + a converter
- The nitrate label trap — why you can't verify the dose
- Best beetroot — ranked by disclosed nitrate
Sources
- He Y, et al. "The effect of beetroot supplementation on blood pressure in older adults: a systematic review and meta-analysis." Nitric Oxide. 2021. PMID: 33905826
- "Effects of beetroot/inorganic nitrate on blood pressure in hypertensive adults" (durability meta-analysis). Nutr Metab Cardiovasc Dis. 2024. PMID: 39117485
- Lundberg JO, et al. "The nitrate-nitrite-nitric oxide pathway in physiology and therapeutics." Nat Rev Drug Discov. 2008. PMID: 18167491
- Massey LK, et al. "Effect of dietary oxalate and calcium on urinary oxalate and risk of formation of calcium oxalate kidney stones." J Am Diet Assoc. 1993. PMID: 8335871
- Crivelli JJ, et al. "Dietary oxalate and kidney stone formation." Am J Physiol Renal Physiol. 2020. PMID: 33379176
- Schwartz BG, Kloner RA. "Drug interactions with phosphodiesterase-5 inhibitors used for the treatment of erectile dysfunction or pulmonary hypertension." Circulation. 2010. PMID: 20606131
- Kloner RA, et al. "Blood pressure and heart rate response to erectile dysfunction drugs / dietary nitrate context." 2018. PMID: 29739235