Use of Beetroot Juice Extract for Hypertension Treatment in Low- and Middle-Income Countries

Effect of red beetroot juice on oxidative status and islet insulin release in adult male rats

INTRODUCTION

Beetroot is rich in inorganic nitrate and it has been shown that inorganic nitrate has beneficial effects on metabolic syndrome. This study aims to investigate the effect of red beetroot juice (RBJ) on carbohydrate metabolism in adult insulin-resistant rats.

MATERIALS AND METHODS

Sixteen male Wistar rats (32 weeks old) were divided into two equal groups: control and RBJ. Treatment with drinking water (control) and 100% RBJ (RBJ) was lasted for 5 weeks. At the end of the 4th week the intraperitoneal glucose tolerance test was performed and at the end of the study period animals were sacrificed and blood and tissue (aorta, heart, and liver) samples were collected. Furthermore, pancreatic islets were isolated and their insulin secretion activity was investigated in different glycemic conditions.

RESULTS

Compared to the control group, RBJ-treated rats showed lower blood glucose and insulin levels in the glucose tolerance test. Serum and tissue levels of nitric oxide in the RBJ group were significantly higher than those in the control group. The liver peroxidation and serum aspartate transaminase levels were significantly increased in the RBJ-treated animals compared to the control group. The islets of RBJ group exhibited lower insulin secretion, especially in 16.7 mM glucose concentration (supraphysiologic condition) than control group.

CONCLUSIONS

RBJ consumption improves glucose metabolism in rats via increasing nitric oxide metabolites in an insulin-independent manner. However, future studies are needed to minimize the potential hepatic adverse consequences.

Diet, herbs and erectile function: A good friendship!

Plants and plant materials have been used for thousands of years to treat and control erectile dysfunction in men. This practice has spanned many cultures and traditions around the world, with the therapeutic effects of many plants attributed to their phytochemical constituents. This review explains how polyphenols (including phenolic acids, flavonoids, terpenoids, carotenoids, alkaloids and polyunsaturated fatty acids) in plants and plant food products interact with key enzymes (phosphodiesterase-5 [PDE-5], angiotensin-converting enzyme [ACE], acetylcholinesterase [AChE], adenosine deaminase [ADA] and arginase) associated with erectile dysfunction. By modulating or altering the activity of these physiologically important enzymes, various bioactive compounds from plants or plant products can synergistically or additively provide tremendous protection against male erectile problems.

Complementary and alternative medicine use and its associated factors among hypertensive patients in Debre Tabor General Hospital, Ethiopia

BACKGROUND

Hypertensive patients have been using complementary and alternative medicine (CAM) to meet their primary healthcare needs within Ethiopia. The use of plant-based medicine is not only common rather it is also a culturally accredited practice, among the people of Ethiopia. However, studies conducted on the prevalence and correlates of herbal medicine (HM) use among hypertensive patients are lacking. Thus, this study aimed to assess CAM use and its associated factors among hypertensive patients.

METHODS

An institutional-based cross-sectional study was conducted on 450 hypertensive patients, visiting the hypertensive care service of Debre Tabor General Hospital from November 1 to December 28, 2020. Interview-guided self-administered questionnaires were used for data collection. Statistical Package for the Social Sciences (SPSS) software version 24.0 was used for data analysis. Univariate and multivariate logistic regression was computed to identify associated factors of CAM use (age, sex, religion, residence, marital status, educational level, monthly income, presence of HTN complication, duration of HTN, and family history of HTN).

RESULTS

Out of the 450 hypertensive patients, 275 (67.8%) participants used complementary and alternative medicine. Herbal medicines used among hypertensive patients were M. stenoptela 105 (62.9%), O. lamiifolium 81 (48.5%), C. aurea 62 (37.1%), R. nepalensis 44 (26.3%), M. piperata 36 (21.6%), H. abyssinica 24 (14.4%), T. schimperi 19 (11.4%), R. abyssinicus 15 (9.0%), and T. foenumgraecum 9 (5.4%). Majority of CAM users 202 (73.5) did not discuss with health professionals about their CAM use. Families and friends 91 (33.1%) were the frontline source of information about CAM use. In a multivariate analysis, female gender patients over 45 years old, rural residence, higher educational level, high average monthly income, presence of complications, greater than 5 years duration of hypertension (HTN), and having a family history of HTN were the independent predictors of CAM use.

CONCLUSION

The prevalence of CAM use among hypertensive patients was high 275 (67.8%). Factors associated with CAM use are similar to those observed in previous studies, but further research is required to further clarify the opportunities and challenges correlated to CAM use in Ethiopia.

A review of some common African spices with antihypertensive potential

Hypertension is the most common non-communicable disease, with about 1.28 billion hypertensive people worldwide. It is more prevalent in men than women and more common in the elderly. Hereditary, age, obesity, lifestyle, diet, alcohol, and chronic metabolic diseases are the major risk factors of hypertension. Treating hypertension is a complex process as there are several mechanisms responsible for its pathogenesis; hence, a combination of several drugs is used for managing hypertension. Drugs used in managing hypertension are expensive and often come with associated side effects; thus, there is need for alternative means of managing this life-threatening disease. These drugs do not achieve the recommended blood pressure target in most people; more so majority of people with hypertension do not follow the treatment regimen religiously. Some Africans have been reported to become normotensive as a result of dietary consumption of spices. Several spices have been used over the years in Africa to manage hypertension. The aim of this review is to evaluate the ethnomedicinal use, bioactive phytochemical composition, bioactive compounds present, and pharmacological applications of spices commonly used in Africa for managing hypertension. Most of the plants used contained polyphenols, flavonoids, tannins, anthraquinone, flavonoids, cardiac glycosides, and saponins. Dietary supplementation of Xylopia aethiopica and other spices in diet have been proven to significantly reduced plasma angiotensin-I-converting enzyme (ACE) than simvastatin (the reference drug). Toxicological, histological, and hematological evaluation revealed that acute and chronic consumption of most of these spices are safe. Studies have also revealed that some of the spices can be used as alternative therapy alongside usual antihypertensive medications. PRACTICAL IMPLICATION: The prevalent rate of hypertension is on the increase in both the developed and developing countries. People often skip medication due to their busy schedule and anti-hypertensive potential side effects; however, this is not the case with food/spices as most people consumed them daily. Deliberate, right combinations and consistent incorporation of spices with proven anti-hypertensive potential into our diet may be of great benefit in normalizing blood pressure and mitigate other complications on the heart and vital organs.

Antioxidant Responses in Hypertensive Postmenopausal Women after Acute Beetroot Juice Ingestion and Aerobic Exercise: Double Blind and Placebo-Controlled Crossover Trial

This study is aimed to analyze the effect of different nitrate concentrations [NO3-] present in beetroot juice (BJ) on salivary oxidative stress markers after acute exercise performance in hypertensive postmenopausal women. Thirteen hypertensive postmenopausal women participated in three experimental sessions, taking different beverages: noncaloric orange flavored drink (OFD), low nitrate (low-NO3-) BJ, and high nitrate (high-NO3-) BJ. The participants performed aerobic exercise on a treadmill, at 65–70% of heart rate reserve (HRR), for 40 min. Saliva samples were collected after an overnight fast, 10 minutes before BJ ingestion at 7 : 20 am (0 ${}^{\prime }$ ), 120 minutes after beverages ingestion (130 ${}^{\prime }$ ), immediately after exercise (170 ${}^{\prime }$ ), and 90 min after exercise (260 ${}^{\prime }$ ). Salivary total protein (TP), catalase activity (CAT), reduced glutathione (GSH), and total antioxidant capacity by ferric-reducing antioxidant power (FRAP) concentrations were analyzed. No interaction (session $\ast$ time) was found among three sessions over time. Catalase area under the curve (AUC) was lower after both low-NO3- and high-NO3- consumption ( $p<0.001$ ), and GSH AUC was lower after high-NO3- ( $p<0.001$ ) compared with OFD. So, the acute intake of BJ with aerobic exercise seems to decrease catalase (in high-NO3- and low-NO3-) and GSH (in high-NO3-), besides not interfering with FRAP in hypertensive postmenopausal women.