The People's Perspective on Medicine

Can You Lower Blood Pressure with Nitric Oxide?

Nitric oxide created in the body relaxes blood vessels and lowers blood pressure. Should you be eating more beets and spinach to boost your levels?

Nitric oxide is a gas originally thought to be important to human health only as an air pollutant. In the 1980s, however, scientists began to realize that this molecule plays many important roles in human physiology. In fact, in 1992, Science magazine named it the molecule of the year. Moreover, in 1998 three scientists, Ferid Murad, Robert Furchgott and Louis Ignarro, shared the Nobel Prize in Physiology and Medicine for their work on nitric oxide.

Will Nitric Oxide Lower Elevated Blood Pressure?

Q. Recently I read that nitric oxide might be useful for high blood pressure and other ailments. Does nitric oxide really help lower blood pressure?

If so, how much of the supplement should a person with high blood pressure take each day? If it works, a lot of people could benefit from this supplement. The information I learned this from stated that leafy dark greens and beetroots were natural sources for nitric oxide.

Spinach and Beets for Better Blood Pressure?

A. Green leafy vegetables and beets–both the roots and the leaves–supply dietary nitrate. In the body, an enzyme called nitric oxide synthetase converts dietary nitrate or the amino acid L-arginine to nitric oxide. This natural compound relaxes blood vessels and lowers blood pressure (Ashworth & Bescos, Nutrition Research Reviews, Dec. 2017). 

A study in healthy older people demonstrated that consuming beet juice rich in nitrates lowered blood pressure, reduced the clotting activity of blood and had anti-inflammatory properties (Raubenheimer et al, Nutrients, Nov. 22, 2017). The effects are relatively short-lived, with blood pressure lower three hours after drinking high-nitrate beet juice but not six hours later.

Nitric Oxide Supplements?

We are not aware of studies utilizing nitric oxide as a dietary supplement. It would be difficult if not impossible to take it as a supplement, since it is actually a gas. Some companies sell supplements containing L-arginine or L-citrulline as “nitric oxide” supplements, but we have not seen any research demonstrating that such products lower blood pressure.

In fact, a review of the research even casts doubt on the use of dietary nitrate to reduce blood pressure (Remington & Winters, JBI Database of Systematic Reviews and Implementation Reports, March 2019). Note: the authors merely cite “insufficient evidence.” We hate to pour cold water on anyone increasing their intake of vegetables. 

Learn More:

To learn more about beet juice, grape juice, pomegranate juice and dark chocolate as foods that can help with blood pressure control, you may wish to read our Guide to Blood Pressure Treatment

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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I can see HUGE drops in my BP from drinking beetroot juice and have it daily now, thinking about changing to twice daily although it’s hard work.

I know the article says 6 hours with relatively small drops, but my readings seem to be very “responsive.” I’ll have a reading around 190/95 (sometimes even higher) in the evening (while taking BP meds daily), then drink a 700ml jug of beetroot juice, and the next morning my BP will be below 150/80 (somehow my diastolic number drops much faster). Other times when I don’t have beets in the house, it’ll stay that high or maybe drop to 170-180/85-90.
Unfortunately, I am prone to kidney stones, with a second one currently in there, so will be finding out what type of stones I get :(
Jill Harris works with Dr Fred Coe, a well respected nephrologist at the University of Chicago.
Many patients with calcium oxylate kidney stones have made it to her Facebook page and told their stories about how spinach especially landed them in the ER with kidney stones.
The site promotes the Harvard oxylate food list and gives other advice on preventing kidney stones.
Spinach is so incredibly high in oxylate that it is the one food that should never be eaten by those with calcium oxylate stones. One person who posted half-jokingly said that there should be a warning label on it.
Beets are high too and need to be limited.

I’ve done a lot of reading in PubMed about nitric oxide (NO) and it’s benefits. Turns out there are at least three pathways that the body uses to generate NO. The first and easiest to supplement is L-Arginine (which should be taken as a combination tablet of L-Arginine/L-Citrulline because it is absorbed better). The second is nitrates from food (beets, celery etc.). The third is sunlight. Turns out our skin recycles other compounds into NO when exposed to sunlight. That might explain why people come back from sunny vacations with lower blood pressure. Sun can get rare here in Seattle in the winter, so I make the effort to get as much as possible when it’s nice out. I mitigate blood pressure using all three methods all the time. Means taking a lot of pills (and I’ve heard good things from taking vitamin C + Garlic pills which I will try soon) but the lack of any downside or side effects to these natural remedies has kept me off prescriptions. Yay!

Are the people taking/using supplements still using their prescription meds? Is Jerome R in Minnesota using any prescribed medications?

Get the recently released book: “China Rx.” Most major drug manufacturers buy their raw materials from China and very few even still have a manufacturing site in America. You’ll be shocked when you read this book.

The blood pressure lowering, DASH diet emphasizes fruits and vegetables for their potassium and magnesium. Only downside to beets and spinach is oxalate content, for those prone to that type of kidney stones.

I have read recent reports that taking beet capsules and/or consuming beets are very helpful for athletes, as they help our hearts with oxygenation…so perhaps they could help with lowering blood pressure as well? Maybe two or three capsules spread out throughout each day, if one would rather not drink or eat beets often? I’d love to see research on this! :-}. Would there be any harm or potential side effects in trying this?

Yes – absolutely it’s possible. I have found that exercise is really the most effective way to lower blood pressure, but nitric oxide works well too. There are a couple of supplements that reliably helped me: lozenges that dissolve in the mouth (and have testing strips to track your progress) and concentrated beet powder. If you take one of the novel blood-thinning drugs
(I take Xarelto for Factor V clotting problems) you can get very red urine from the beet powder and you need to be able to know if it’s blood or beets that’s causing this. I don’t get the same effect from the lozenges. Exercise and nitric oxide have solved my hypertension problems. Discovery of the NO factor in heart disease won a Nobel Prize decades ago.

I have noticed a significant improvement of my usually high blood pressure numbers for at least part of the day after I have eaten sliced/pickled beets for supper the previous evening.

I had been taking 40 mg/day of Quinaprill, and that seemed to get my blood pressure down to
the ‘pre-hypertensive’ range. But with the new blood pressure guidelines out, my Doctor wanted it lower.

I did some research, and found out about ‘L-Arginine,’ a supplement that your body converts to Nitric Oxide.I started taking 1000 mg twice day [in addition to the Quinapril], and it dropped my blood pressure down to the normal range…Systolic [115-130],,,Diastolic [55-75]
When I show them, the record of my blood pressure reads, they really seem impressed.

I had triple by-pass surgery 35 years ago. I’m now 81 and in good health by following my Dr’s orders of using statins and eating right (most of the time). I started drinking a shot glass of beet juice every night about a year ago. About 8 mos. into it, I have a better pulse. My blood pressure is better. But my pulse has always been high. Upper 90s but now it’s in the 70s and sometimes 60s. I’m pretty sure it’s thanks to the beet juice.

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