Beetroot Juice and High Blood Pressure

Question: I have heard that beetroot juice is the wonder cure for high blood pressure. My friends are encouraging me to stop my medications and just drink beetroot juice twice a day. What is your advice?

Answer: High blood pressure, also called hypertension, is often called the “silent killer” because most people don’t feel sick when they have it, yet it can cause serious health problems over time.

Globally, high blood pressure affects more than 1.2 billion people and is a leading cause of death. It is especially common in adults over 40, but younger people are also being affected because of poor diet, stress, poor sleep, and lack of exercise. Countries with fewer health resources often face greater challenges because many people go undiagnosed or untreated. In wealthier countries treatment is more available, but such lifestyle habits as eating too much salt, being overweight, tobacco and alcohol use, and insufficient exercise and sleep keep the problem widespread.

The main causes of high blood pressure are a mix of lifestyle and inherited (genetic) factors. Eating foods high in salt, sugar, and unhealthy fats, being overweight, smoking, drinking alcohol, less than adequate restful sleep, and not exercising regularly all raise blood pressure. Family history also plays a role, meaning that if your parents have high blood pressure, you are more likely to develop it too. Stress and aging also make blood vessels stiffer, which raises blood pressure. Some medical conditions raise blood pressure levels, such as hormonal disorders, diabetes, kidney diseases, and sleep apnea (often accompanied by loud snoring), among others.

If high blood pressure is not controlled, it can lead to serious complications. The most dangerous include stroke (when blood flow to the brain is blocked or a blood vessel bursts), heart attack (when blood flow to the heart is blocked), heart failure (when the heart muscle becomes weak and cannot pump efficiently), kidney disease, and vision loss. Because there are usually no early symptoms, many people do not know they have high blood pressure until these complications occur. This is why high blood pressure is called the silent killer.

Consumption and Effectiveness

Beetroot juice is rich in nitrate, a natural chemical compound found in many vegetables. Upon consumption, nitrate is changed by friendly bacteria in the mouth (oral microbiome) into nitrite, and then into nitric oxide, which relaxes the blood vessels. Relaxed vessels can lower blood pressure (BP). This “nitrate → nitrite → nitric oxide” pathway is well documented in human studies. 

What do recent studies show regarding the effectiveness and safety of drinking beetroot juice? A high-quality study in people with hypertension found that about 250 milliliters of nitrate-rich beetroot juice daily for four weeks lowered clinic-measured and 24-hour BP by roughly an amount similar to what would be expected for some people taking one BP pill per day. Blood vessel function also improved. A 2024 systematic review and meta-analysis (the strongest type of evidence that combines many trials) concluded that beetroot juice lowers clinic-measured systolic blood pressure (the top number in BP readings) in people with hypertension, typically with daily doses providing 200 to 800 milligrams nitrate (often 250 to 500 milliliters beetroot juice).^[1] Effects on 24-hour blood pressure were smaller and less consistent. 

Newer research adds an important nuance. A 2024 well-designed study randomized trial^[2] in older adults with treated hypertension did not find sustained BP improvements after several weeks of nitrate-rich beetroot juice “treatment,” suggesting the benefit may vary by person and setting. In 2025 a study in older adults showed that four weeks of nitrate-rich beetroot juice drinking shifted the oral microbiome toward more nitrate-reducing bacteria—supporting the idea that the microbiome helps drive any blood reducing effect.^[3]

Beetroot juice may help lower BP for some people through its nitrate content and influence on the oral microbiome, but it is one tool among many.

Bottom line on effectiveness? Drinking beetroot juice can modestly lower systolic BP for some people, especially those with hypertension, but results are not guaranteed and may fade when you stop drinking it, just as what happens with prescribed BP medicines. Think of it as an adjunct to, not a substitute for, proven lifestyle interventions (exercise, maintaining ideal weight, avoiding tobacco and alcohol, and getting enough sleep) and appropriate medications as needed. 

How to use it safely (with your doctor’s guidance):

• Talk to a qualified health professional first. Beetroot juice can interact with BP medicines by adding to their BP-lowering effect. Your doctor can advise on dose, timing, and routine monitoring of your blood pressure for efficacy and safety.
• Typical research doses: 250 to 500 milliliters (1 to 2 cups) per day of beetroot juice (often split), providing about 200 to 800 milligrams nitrate. Check labels on the various products available to you—nitrate content varies from product to product. One large beetroot (the size of a grapefruit, 300 to 400 grams) or two medium-sized beetroots (each 150 to 200 grams, the size of a tennis ball) or about 400 grams will provide about a cup of beetroot juice.
• Raw beetroot (and nitrite-rich leafy vegetables) retain more nitrites than when cooked, and adequate time in the mouth and thorough chewing help bacteria convert nitrites.
• Mind the mouthwash. Strong antiseptic mouthwashes (e.g., chlorhexidine) can kill the helpful oral bacteria that convert nitrate and may raise BP, blunting the beetroot juice’s effect. Avoid routine antiseptic mouthwash unless your dentist or doctor recommends it. Regular flossing and brushing are generally sufficient.
• Common, usually harmless effects: pink urine or stools and temporary stomach upsets may occur. If you have a history of kidney stones, consult with your physician before using beetroot juice regularly.

Lifestyle still does the heavy lifting. No juice replaces the basics that consistently lower BP:

• Reduce salt (aim <1,500 to 2,000 milligrams sodium/day if advised).
• Move more (≥150 minutes/week of moderate activity).
• Maintain a healthy weight, avoid alcohol, don’t smoke, and sleep well.
• Beetroot juice can fit into a vegetable-rich, DASH-style^[4] eating pattern alongside other nitrate-rich veggies (spinach, arugula, celery). The Adventist Health Study 2 confirmed that following a balanced vegetarian diet is associated with less hypertension.

Treating other medical conditions that can cause high blood pressure is prudent. Medications and follow-up matter. If you were prescribed medications for blood pressure control, talk to your doctor or health-care provider before making adjustments. Additions such as beetroot juice should be layered on top of medications and lifestyle—not instead of them. If you have the means, check your home blood pressure regularly, bring the readings to appointments, and plan regular follow-ups to help monitor and adjust your care.

Conclusion

Beetroot juice may help lower BP for some people through its nitrate content and influence on the oral microbiome, but it is one tool among many. Use it only with medical advice, keep up the lifestyle foundations, take your medications as prescribed, and follow up regularly to stay on target. 

The goal is to have a healthy blood pressure and quality of life. That is why regular blood pressure checks, healthy lifestyle choices, and, when needed, medications are so important. High blood pressure may be a silent disease initially, but with awareness and intentional treatment, its deadly effects can be prevented.

We have been fearfully and wonderfully made, and our Creator God, through His Word, prophets, and even health science, has given us the blessing of the best information to live life to the full. We wish you good health and remind you of John’s prayer for his friend Gaius: “Dear friend, I pray that you may enjoy good health and that all may go well with you, even as your soul is getting along well” (3 John 2, NIV).

Source: adventistreview.org