Background Nitric oxide (NO) is central in the process of vasodilatation (1). Limited bioavailability of NO often associates with endothelial dysfunction, a precursor to atherogenesis (1). Such dysfunction is often observed in patients with chronic conditions such as Rheumatoid Arthritis (RA) (2) and Chronic Obstructive Pulmonary Disease (COPD) (3). Common therapies for this include the administration of nitrate-rich medication. However, in the general population beetroot juice supplementation has been shown to increase NO bioavailability (4). It could therefore have beneficial effects on endothelial function of these patients as well.

Objectives To evaluate the effects of short-term beetroot juice supplementation on endothelial function in patients with RA and COPD.

Methods A total of 28 patients, 9 with RA, 9 with COPD and 10 healthy controls participated in the study. Following consent, they were asked to report at the testing venue (Ultrasonography Laboratory, General Hospital of Trikala) early in the morning, following an overnight fast. Demographic and disease characteristics were recorded; height, weight, classical risk factor for cardiovascular disease and body composition were assessed. Endothelial function was assessed using flow mediated vasodilatation. They randomly received either beetroot (experimental leg) or blackcurrant juice (control leg), which they consumed daily for two weeks. Thereafter they were re-evaluated. Following a two-week washout period, they crossed over to the other leg of the study.

Results There was no difference in pre-occlusion diameter between any of the time-points. Endothelial function was significantly improved following beetroot juice consumption for both patient groups (RA: 2.6% [0.9 – 6.2] vs 10.7% [6.2 – 11.7]; p=0.013. COPD: 3.4% [1.2 – 4.8] vs 7.8% [3.6 – 10.2]; p=0.034) while it remained relatively unaffected by blackcurrant consumption (Overall: 3.9% [0 – 5.1] vs 4.2% [2.3 – 6.1]; p=0.26).

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Figure 1

Conclusions A two week consumption of beetroot juice seems to be able to improve endothelial function among patients with RA and COPD. This could elicit significant health benefits. Further research to investigate the benefits of longer-term use on endothelial function and related cardiovascular health, as well as disease symptoms, and quality of life is advocated.

References

1. Moncada, S. and Higgs, E.A. The discovery of nitric oxide and its role in vascular biology. British Journal of Pharmacology 2006, 147: S193–S201.

2. Sandoo, A. et al. Vascular function and morphology in rheumatoid arthritis: a systematic review. Rheumatology 2011, 50 (11): 2125–2139.

3. Clarenbach, C.F. Determinants of endothelial function in patients with COPD. European Respiratory Journal 2013, 42 (5): 1194–1204.

4. Clifford, T. et al. The Potential Benefits of Red Beetroot Supplementation in Health and Disease. Nutrients 2015, 7.4: 2801–2822.

References

Disclosure of Interest None declared