Inorganic Nitrate as a Treatment for ANOCA: NO-ANOCA

The purpose of this study is to see if inorganic nitrate in the form of beetroot juice helps blood flow and physical fitness in women with ANOCA and CMD. The main questions it aims to answer are: AIM 1: Test the hypothesis that fourteen days of nitrate rich beetroot juice will increase cardiac perfusion and improve quality of life compared to placebo. AIM 2: Test the hypothesis that fourteen days of nitrate rich beetroot juice will increase physical fitness and reduce angina and dyspnea symptoms compared to placebo. Exploratory AIM 3: Test the hypothesis that fourteen days of nitrate rich beetroot juice will improve vascular health and function. Participants will: * Take study beverage for 4 weeks total. * Stress Cardiac magnetic resonance imaging and 12 lead electrocardiograms * Complete questionnaires * Cycling exercise test * Non invasive vascular testing * Blood draws

NCT Number	NCT06948201
Lead Sponsor	University of Virginia
Conditions	Coronary Microvascular Dysfunction (CMD), Angina Patients With Non-obstructive Coronary Artery Disease
Enrollment	8 participants
Start Date	2025-05
Primary Completion	2026-05 (estimated)
Study Completion	2026-06 (estimated)
Updated on ClinicalTrials.gov	2025-04-29