L-Arginine in cardiovascular disease: dream or reality?
Why the study?
Does L-arginine improve outcomes in patients with cardiovascular disease?
Population
Patients with cardiovascular diseases, including those with atherosclerosis risk factors, diabetes mellitus…
Design
Review
Authors
Discussion
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Member takes
Implication
L-arginine should not yet alter clinical practice in CVD; leaves open its role in CAD and HF pending prospective outcome trials.
Key Points
- To review the biological mechanisms and therapeutic effects of L-arginine supplementation across diverse cardiovascular conditions and vascular risk factors.
- Synthesized evidence on nitric oxide-dependent and nitric oxide-independent pathways regulated by L-arginine.
- Evaluated physiological and clinical outcomes following oral or parenteral L-arginine administration in hypertension, atherosclerosis, coronary artery disease, and heart failure.
- L-arginine administration restores brachial artery endothelial function and enhances coronary microcirculation in hypercholesterolemia, hypertension, and coronary artery disease, but exhibits no therapeutic effect on endothelial function in diabetes mellitus.
- Vascular benefits occur via enhanced nitric oxide synthesis as well as nitric oxide-independent actions, including endothelial membrane depolarization, pH regulation, antioxidant effects, and modulation of coagulation.
Structured PICO
Does L-arginine improve outcomes in patients with cardiovascular disease?
P
Population
Patients with cardiovascular diseases, including those with atherosclerosis risk factors (hypercholesterolemia, hypertension, smoking), diabetes mellitus, coronary artery disease, and heart failure
I
Intervention
L-arginine
While L-arginine shows mechanistic promise in improving endothelial function, large-scale prospective trials are required to establish its clinical efficacy in cardiovascular disease.
Limitations
- Lack of large-scale prospective studies evaluating the effects of long-term treatment
Cite This Study
Tousoulis et al. (2002) studied this question.