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Beetroot and blood pressure

Beetroot and blood pressure. Amrita Ahluwalia William Harvey Research Institute Barts & The London Medical School. High blood pressure- The silent killer!. 1/3 of all deaths caused by CVD. Pressures >140/85. Fruit and vegetables reduce blood pressure. DASH study 459 participants

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Beetroot and blood pressure

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  1. Beetroot and blood pressure Amrita Ahluwalia William Harvey Research Institute Barts & The London Medical School

  2. High blood pressure-The silent killer! 1/3 of all deaths caused by CVD Pressures >140/85

  3. Fruit and vegetables reduce blood pressure DASH study 459 participants 8 weeks Appel LJ et al,NEJM 1997;336:1117-1124

  4. Vitamins increase all cause mortality! Bjelakovic, G. et al. JAMA 2007;297:842-857

  5. Dietary nitrate • Greatest protection of CVD afforded by green leafy vegetables (Joshipura et al, Anal Intern Med, 2001) • Bioactivation of nitrate through enterosalivary circulation to nitrite and thence nitric oxide. • Inorganic nitrite releases NO to cause vasodilation in humans

  6. Dietary nitrate • Greatest protection of CVD afforded by green leafy vegetables (Joshipura et al, Anal Intern Med, 2001) • Bioactivation of nitrate through enterosalivary circulation to nitrite and thence nitric oxide. • Inorganic nitrite releases NO to cause vasodilation in humans

  7. Nitric Oxide NOS L-Arginine NO. cGMP O2 NO2- NO3-

  8. Nitric Oxide NOS L-Arginine NO. Chemical acidification NO2- Bacterial anaerobes NO3- Benjamin et al , Nature. 1994;368:502 Lundberg , Weitzberg et al , Gut. 1994;35:1543-1546.

  9. Entero-salivary circulation • NO3- • NO2- • NO

  10. Dietary nitrate • Greatest protection of CVD afforded by green leafy vegetables (Joshipura et al, Anal Intern Med, 2001) • Bioactivation of nitrate through enterosalivary circulation to nitrite and thence nitric oxide. • Inorganic nitrite releases NO to cause vasodilatation in humans

  11. The beetroot! Healthy volunteers (normotensive) Beetroot juice (500ml) Assessed: Plasma Nitrate/nitrite Blood pressure

  12. Plasma Nitrate/Nitrite

  13. Ingestion of dietary nitrate elevates circulating nitrate and nitrite Healthy Volunteers N=14 Juice [nitrate]=45±2.6 mM Webb et al. 2008, Hypertension, 51, 1-7.

  14. The enterosalivary circulation Normal Healthy Volunteers N=6 Juice [nitrate]=34 +/- 0.1 mM Webb et al. 2008, Hypertension, 51, 1-7.

  15. Blood Pressure

  16. Elevation of circulating nitrite correlates with a decrease in blood pressure

  17. The enterosalivary circulation and blood pressure

  18. Does nitrate supplement act like beetroot? • What is the dose-response for beetroot?

  19. Does nitrate supplement act like beetroot? • What is the dose-response for beetroot?

  20. Nitrate supplement mimics beetroot juicePlasma Nitrate/Nitrite Normal Healthy Volunteers N=18 KNO3=24 mmol KCl control

  21. Nitrate supplement mimics beetroot juice Blood pressure Normal Healthy Volunteers N=20 KNO3=24 mmol Kapil et al 2010 Hypertension in press

  22. Does inorganic nitrate act like beetroot? • What is the dose-response for beetroot?

  23. Dose-dependent effects

  24. • NO3- • NO2- • NO

  25. Nitric oxide and hypertension X NOS L-Arginine NO. Blood vessel nitrite reductase NO2- Bacterial anaerobes NO3-

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