How to "Beet" Hypertension

BeetsDrinking roughly one cup of raw beet juice daily can markedly reduce blood pressure, while simultaneously quelling systemic inflammation and improving lipid profiles in people with hypertension.

Dr. Sedigeh Asgary and colleagues at the Isfahan Cardiovascular Research Center, Iran, assessed the pressure-modulating potential of freshly pressed beet juice, as well as that of cooked beets, in 24 hypertensive women and men not on anti-hypertensive medications.

The patients were instructed to drink either 250 ml of raw beet juice (approximately 1.06 cups) or 250 ml of cooked beet juice every day for two weeks. The groups then switched from raw to cooked juice, or vice versa, for an additional two weeks.

The results, published in December 2016 in the Journal of Human Hypertension, were pretty rosy….er, make that magenta.

Daily consumption of raw beet juice lowered mean systolic blood pressure by roughly 7 mmHg, from a baseline average of 133.9 mmHg to 127.3 mmHg. Diastolic pressure went from a baseline of 82.7 to 78.1 mmHg.

The cooked beet juice was not quite as effective, but still exerted a measurable BP lowering effect, with systolic pressure declining by 5 mmHg, and diastolic dropping by approximately 3 mmHg on average.

Daily beet consumption –particularly the raw beet juice—also attenuated a myriad of cardiovascular risk factors. The mean high-sensitivity CRP level dropped from 1.1 to 0.7 ng/ml; Interleukin (IL)-6 went from 2.2 to 1.6 ng/ml; and TNF-alpha went from a mean 4.19 to 3.18 ng/ml. All of these are reliable markers of systemic inflammation, suggesting that the humble beetroot contains potent anti-inflammatory compounds.

Go Raw

Indicators of vessel dilation showed marked improvements: mean ICAM levels went from 143.9 ng/ml at baseline to 119.6 after two weeks of raw beet juice, and VCAM dropped from a mean of 657.5 to 515 ng/ml.

The raw beet juice—though not the heated juice—also lowered total cholesterol from a baseline of 189.9 to 169.9 ng/dl. LDL went from 117.7 to 103 (Asgary S, et al. J Human Hyperten. 2016; 30: 627-632).

Beets, from the family Chenopodiaceae, are high in folate, fiber, manganese and potassium. They’re known to be anti-carcinogenic due to their betacyanin levels, a pigment which gives them their rich red color.

They are also a dietary source of nitrates, which are used to make nitric oxide (NO), a strong vasodilator important in regulating blood pressure.

The anti-inflammatory effect observed in the Asgary study is likely due to the betaine content in these widely available and inexpensive root vegetables. Betaine helps protect cells and organs from stress, calms inflammation and also reduces risk of vascular disease. Murray and colleagues have suggested that the anti-inflammatory properties of compounds contained in beets may also assist with the anti-hypertensive effect (Murray MT, Pizzorno  JE, & Pizzorno L. (2005). The Encyclopedia of Healing Foods. Simon and Schuster).

Beeturia—the red or pink coloration of urine (and feces)—is the main consequence of consuming high quantities of beets or beet juice. While it may be frightening for people experiencing it for the first time, it is perfectly harmless and results from pigments contained in the beets.

The only true caveat about beets is their high oxalate content. People with a history of oxalate kidney stones should probably not use beet juice to lower blood pressure.

These roots have a strong flavor, so someone new to beet juice, should try mixing it with carrot juice or another vegetable juice at first.

Drug-Free Options?

Despite the vast quantities of drugs that the medical industry has hurled at hypertension, the problem has not gone away.

The Centers for Disease Control and Prevention estimate that 75 million Americans, or 1 in 3 adults, has hypertension, as defined by a blood pressure of 140/90 mmHg or higher. This leads to around 9 million deaths annually, with 50% of these deaths due to stroke (CDC, 2015). The numbers continue to rise despite widespread prescription of ACE inhibitors and beta-blockers.

These drugs, though generally safe, are not without some adverse effects. They can also be costly, leading many hypertensive people to seek natural alternatives. Beets, which sell for between $1-2 per pound in most supermarkets, seem like a pretty good option.

Asgary and colleagues suggest that future studies should look at whether beetroot juice would have clinical efficacy as a long term “therapy” for hypertension and cardiovascular disease.

Ginseng is another natural option for managing high blood pressure, though the results of ginseng studies have been a bit more variable than those of beetroot.

A Role for Ginseng?

A recent meta-analysis of 17 studies (12 for Asian ginseng, 5 for American ginseng) looking at the impact of this root on systolic, diastolic and mean ginseng root finalarterial pressure in a wide range of human subjects (healthy adults, adults with hypertension, and adults with diabetes, obesity or metabolic syndrome) led to the ultimate conclusion that neither the Asian nor the American species of ginseng had a clinically or statistically significant overall impact on blood pressure (Komishon AM, et al. J Human Hypertens. 2016: 30 619-626).

That said, the authors—a team of investigators at major Canadian universities—note that use of ginseng does have favorable effects on systolic blood pressure in people with diabetes, metabolic syndrome or obesity. Differences in response to ginseng supplementation were related to body mass index.

Herbs often have different effects in different people based on their physiology. The Canadian data, though definitely not definitive, suggest that ginseng may offer the most benefit for those who need it the most: the people with significant co-morbidities and high CVD risk profiles.

It is also important to note that the authors did not specify which type of ginseng was the most favorable overall.

This may be important because American and Asian ginseng appear to have different physiological effects. While American ginseng calms the central nervous system and helps the body deal more effectively with stress and inflammation, Asian ginseng may offer protection for neurodegenerative disease and be more beneficial for reducing risk of heart disease and hypertension (Mercola, J., MD. (June 22, 2015). The Many Health Benefits of Ginseng)

Future meta-analyses or systematic reviews should differentiate between the two types of ginseng in hopes that a clearer picture can be formed.

Ginseng does need to be used carefully. Pregnant or breastfeeding women should be particularly cautious. It is probably not a good option for people already taking diabetes medications, warfarin or other anti-coagulants, monoamine oxidase inhibitors (MAOIs), anti-psychotics or morphine.

If using ginseng in whole form, it is best not to peel the roots, as the peel contains many of the important bioactive compounds. .

In today’s society, chronic diseases like hypertension are definitely making headlines—and affecting bottom lines.

Those facing a strict drug regime for the rest of their lives are looking for safer, more natural ways to alleviate their symptoms and help them on their road to health. The good news from these two recent papers is that both ginseng and beets show promise as contenders for treating hypertension naturally.

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Elizabeth Herbert is a graduate student and clinical intern in the clinical nutrition program at The Maryland University of Integrative Health. Upon graduation this Spring, she plans to sit for the certified nutrition specialist (CNS) board exam before beginning clinical practice in PA.