Effects of chronic nitrate supplementation on blood pressure in adults: a systematic review and meta-analysis of randomized clinical trials.

Sodium nitrate supplementation did not significantly reduce systolic blood pressure compared to placebo.

• Mean difference in SBP: -3.81 mm Hg (95% CI: -10.05 to 2.43 mm Hg)
• Result was not statistically significant
• Analysis used a random-effects model with Hartung-Knapp adjustment and the inverse variance method
• Six studies with n = 181 participants were included in the analysis

Sodium nitrate supplementation did not significantly reduce diastolic blood pressure compared to placebo.

• Mean difference in DBP: -2.00 mm Hg (95% CI: -4.37 to 0.38 mm Hg)
• Result was not statistically significant
• Six placebo-controlled RCTs were included, involving 181 participants
• Participants were predominantly male (59%) and over 50 years of age

Sodium nitrate supplementation did not significantly alter resting heart rate compared to placebo.

• Mean difference in RHR: 0.34 bpm (95% CI: -5.68 to 6.36 bpm)
• Result was not statistically significant
• Analysis was conducted across the same six eligible studies

The included studies were assessed as having a low risk of bias based on the PEDro scale.

• Average PEDro score was 8.16 points, indicating low risk of bias
• Risk of bias assessment was conducted using the PEDro scale
• Six studies were eligible for analysis

Only six randomized clinical trials met inclusion criteria for this meta-analysis of chronic sodium nitrate supplementation on blood pressure.

• Searches were conducted in PubMed, Cochrane, LILACS, Web of Science, SCOPUS, and grey literature in June 2025
• Inclusion criteria required placebo-controlled RCTs with participants aged ≥18 years and study duration of at least one week
• Studies using beetroot juice as intervention and animal studies were excluded
• Total sample across eligible studies was n = 181 participants, with 59% male and majority over 50 years of age