How to beet hypertension in pregnancy: is there more to beetroot juice than nitrate?

Pregnancy is associated with a number of structural and functional cardiovascular adaptations that ensure the fetus is adequately supplied with nutrients throughout all phases of growth and development. Failure to meet the increased metabolic demands can lead to significant maternal and fetal morbidity. Maternal hypertension, either pre-existing or developing during pregnancy, is complicated by the limitations of our current anti-hypertensive medication. The mainstays of anti-hypertensive treatment, such as angiotensin-converting enzyme inhibitors (ACEi), angiotensin II receptor antagonists/blockers (ARBs/Sartans) and thiazide diuretics are associated with an increased risk of congenital abnormalities to the developing fetus (NICE, 2019). As such, there remains a need to increase the available options for treatment of hypertension in pregnancy.