Scientists at Wake Forest Baptist Medical Center have found that a daily dose
of beetroot juice significantly improved exercise endurance and blood pressure
in elderly patients with heart failure with preserved ejection fraction
The study is published in the current
online edition of the Journal of the American College of Cardiology-Heart Failure.
Exercise intolerance – shortness of
breath and fatigue with normal amounts of exertion -- is the primary symptom of
HFPEF and is due partly to non-cardiac factors that reduce oxygen delivery to
active skeletal muscles. HFPEF is a recently
recognized disease that reflects how the left ventricle of the heart pumps with
each beat. It occurs primarily in older women and is the dominant form of heart
failure, as well as the most rapidly increasing cardiovascular disorder in this
Emerging evidence suggests
that dietary inorganic nitrate supplementation has beneficial effects on blood
pressure control, vascular health, exercise capacity and oxygen metabolism.
The Wake Forest Baptist researchers
enrolled 19 people in a double-blinded, randomized safety study to determine
which was better at improving exercise intolerance, a single dose or a daily
dose of the juice given over multiple days. The beetroot juice used is produced
by a company in the United Kingdom and is not commercially available in this
First, aerobic endurance and blood
pressure were measured after the participants received either a single dose of
beetroot juice or a placebo.
researchers then administered a daily dose of beetroot juice to all 19 patients
for an average of seven days, and measured endurance and blood pressure again. The
juice dose in the study was equivalent to 2.4 ounces containing approximately 6
millimoles of inorganic nitrate.
The team found that the daily dosing
of beetroot juice improved aerobic endurance by 24 percent after one week, as
compared to the single dose which produced no improvement. Aerobic endurance
was measured as cycling time to exhaustion at a fixed workload lower than their
Another finding was that consumption
of the juice significantly reduced resting systolic blood pressure in both the single
and daily dose groups by 5 to 10 mmHg.
No adverse events were associated with
“Although larger trials need to be
conducted, these initial findings suggest that one week of daily beetroot juice
could be a potential therapeutic option to improve aerobic endurance in
patients with HFPEF, which has implications for improving everyday activities
and quality of life,” said Dalane Kitzman, M.D., professor of internal medicine
at Wake Forest Baptist and senior author of the study.
This work was partially supported by
NIH grants R01AG18915, R01AG045551, P30AG021332, HL058091, The Kermit Glenn
Phillips II Chair in Cardiovascular
Medicine, Wake Forest School of
Medicine, and the Moritz Chair in Geriatrics in the College of Nursing and
Health Innovation at the University of Texas at Arlington. It was also
partially supported by the Translational Science Center of the Reynolda Campus
of Wake Forest University.
Co-authors of the study are: Joel Eggebeen, M.S., and Timothy M. Morgan, Ph.D.,
of Wake Forest Baptist; Mark Haykowsky,
Ph.D., of University of Texas at Arlington; Daniel B. Kim-Shapiro, Ph.D., Swati
Basu, Ph.D., Peter Brukaker, Ph.D., and Jack Rejeski, Ph.D., of Wake Forest
Conflict of interest: Kim-Shapiro
holds a patent related to the use of nitrite in cardiovascular conditions and
has a financial interest in Beverage Operations LLC, a Florida-based producer
of a beetroot juice beverage.