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Inorganic nitrate and the cardiovascular system
  1. V Kapil,
  2. A J Webb,
  3. A Ahluwalia
  1. Queen Mary University of London, Clinical Pharmacology, William Harvey Research Institute, Barts & The London School of Medicine and Dentistry, Charterhouse Square, London, UK
  1. Correspondence to Dr Amrita Ahluwalia, Barts and The London School of Medicine and Dentistry, London EC1M 6BQ, UK; a.ahluwalia{at}


Fruit and vegetable-rich diets reduce blood pressure and risk of ischaemic stroke and ischaemic heart disease. While the cardioprotective effects of a fruit and vegetable-rich diet are unequivocal, the exact mechanisms of this effect remain uncertain. Recent evidence has highlighted the possibility that dietary nitrate, an inorganic anion found in large quantities in vegetables (particularly green leafy vegetables), may have a part to play. This beneficial activity lies in the processing in vivo of nitrate to nitrite and thence to the pleiotropic molecule nitric oxide. In this review, recent preclinical and clinical evidence identifying the mechanisms involved in nitrate bioactivity, and the evidence supporting the potential utility of exploitation of this pathway for the prevention and/or treatment of cardiovascular diseases are discussed.

  • Hypertension
  • nitrates
  • nitric oxide

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  • Funding British Heart Foundation.

  • Competing interests AA is a director of Heartbeat Ltd.

  • Provenance and peer review Commissioned; externally peer reviewed.