Evidence mapPaperPMID 40128734Full record

SynthesisNutrition journal2025

Plasma nitrate, dietary nitrate, blood pressure, and vascular health biomarkers: a GRADE-Assessed systematic review and dose-response meta-analysis of randomized controlled trials.

Mostafa Norouzzadeh, Minoo Hasan Rashedi, Shadi Ghaemi, Niloufar Saber, Artemiss Mirdar Harijani, Hamzeh Habibi, Soroush Mostafavi, Fatemeh Sarv, Hossein Farhadnejad, Farshad Teymoori and 2 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Nutrition journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Mostafa Norouzzadeh *Student Research Committee, Iran University of Medical Sciences, Tehran, Iran.
Minoo Hasan Rashedi *Student Research Committee, Iran University of Medical Sciences, Tehran, Iran.
Shadi GhaemiDepartment of Community Nutrition, Tehran University of Medical Sciences, Tehran, Iran.
Niloufar SaberNutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Artemiss Mirdar HarijaniStudent Research Committee, Iran University of Medical Sciences, Tehran, Iran.
Hamzeh HabibiDepartment of Cardiology, School of Medicine, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
Soroush MostafaviDepartment of Cardiology, School of Medicine, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
Fatemeh SarvRasool Akram Medical Complex Clinical Research Development Center (RCRDC), Iran University of Medical Sciences, Tehran, Iran.
Hossein FarhadnejadNutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Farshad TeymooriStudent Research Committee, Iran University of Medical Sciences, Tehran, Iran. Teymoori.f@iums.ac.ir.
Mohsen KhaleghianDepartment of General Surgery, School of Medicine, Hazrat-Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran. Khaleghian.m@iums.ac.ir.
Parvin MirmiranNutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHypertension and vascular dysfunction are major health concerns, and studies have suggested different interventions, including dietary nitrate (NO3), to improve it. We sought to elucidate the effects of dietary NO3 on plasma NO3 and nitrite (NO2) levels and to determine the shape of the effect of dietary NO3 on blood pressure (BP) and vascular health biomarkers.

methodsPubMed, Scopus, and Web of Science were searched up to February 2024 for eligible randomized controlled trials (RCTs). The pooled results were reported as weighted mean differences (WMD) and 95% confidence intervals (CIs).

resultsOur analysis of 75 RCTs involving 1823 participants revealed that per each millimole (mmol) increase in the administered NO3 dose, both acute (WMD: 32.7µmol/L; 95%CI: 26.1, 39.4) and chronic-term (WMD: 19.6µmol/L; 95%CI: 9.95, 29.3) plasma NO3 levels increased. Per each mmol increase in NO3 intake, a reduction in systolic BP levels was observed in the acute (WMD: -0.28mmHg; 95%CI: -0.40, -0.17), short-term (WMD: -0.24mmHg; 95%CI: -0.40, -0.07), and medium-term (WMD: -0.48mmHg; 95%CI: -0.71, -0.25) periods. Furthermore, a decrease in diastolic BP for each mmol increase in NO3 intake (WMD: -0.12 mmHg; 95% CI: -0.21, -0.03) was shown. Moreover, a linear dose-response relationship was indicated between each mmol of NO3 intake and medium-term pulse wave velocity (WMD: -0.07 m/s; 95%CI: -0.11, -0.03), medium-term flow-mediated dilation (WMD: 0.30%; 95%CI: 0.15, 0.46), and medium-term augmentation index (WMD: -0.57%; 95%CI: -0.98, -0.15).

conclusionWe observed dose-dependent increases in plasma NO3 and NO2 levels, along with consequent reductions in BP and enhancements in vascular health following dietary NO3 supplementation. Future high-quality, population-specific studies with optimized dietary NO3 dosages are needed to strengthen the certainty of the evidence. REGISTRATION: The protocol for this systematic review was registered in PROSPERO under the registration number CRD42024535335.

Indexed as

Blood PressureDietNitratesAdultBiomarkersDose-Response Relationship, DrugFemaleHumansHypertensionMaleMiddle AgedNitritesRandomized Controlled Trials as TopicBiomarkersNitratesNitritesCardiometabolic risk factorsControlled clinical trialHypertensionNitratesPreventive cardiologyVascular stiffness

Identifiers

PMID40128734
PMCPMC11931885

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.