The influence of dietary nitrates from plant-based sources on vascular function and hypertension management

Hypertension is a major public health challenge in Uzbekistan, driving the need for accessible dietary strategies. This study investigated the association between habitual dietary nitrate intake from plant-based sources and vascular health in an Uzbek adult population. In a cross-sectional study of 300 participants (150 hypertensive, 150 normotensive), daily nitrate intake was estimated using a validated food frequency questionnaire tailored to local foods. Vascular outcomes included office blood pressure, flow-mediated dilation (FMD), and carotid-femoral pulse wave velocity (cf-PWV). Median dietary nitrate intake was significantly lower in the hypertensive group compared to the normotensive group (162 mg/day vs. 215 mg/day, p < 0.001). A strong inverse correlation was observed between nitrate intake and systolic blood pressure (Spearman's rho = -0.41, p < 0.001). In multiple linear regression models adjusted for age, sex, BMI, and smoking, every 50 mg increase in daily nitrate intake was associated with a 4.25 mmHg lower systolic blood pressure (β = -0.29, p < 0.001) and a 0.52% improvement in FMD (β = 0.25, p < 0.001). Participants in the highest tertile of nitrate consumption had significantly better vascular parameters than those in the lowest tertile (p for trend <0.001).