Key result
In patients with PAOD and hyperhomocysteinemia, 8 weeks of L-arginine significantly improved flow-dependent vasodilation (10.2% vs placebo 8.9%), whereas B vitamins had no significant effect.
Why the study?
Does oral treatment with B vitamins or L-arginine improve endothelium-dependent vasodilation in patients with peripheral arterial occlusive disease and hyperhomocyst(e)inemia?
RCT (n=27)
Double-blind
assigned
Does oral treatment with B vitamins or L-arginine improve endothelium-dependent vasodilation in patients with peripheral arterial occlusive disease and hyperhomocyst(e)inemia?
Absolute Event Rate: 10.2% vs 8.9%
p-value: p=n.s. for B vitamins
L-arginine, but not B vitamins, improves endothelial function in patients with PAOD and hyperhomocysteinemia, suggesting that ADMA and oxidative stress drive the dysfunction rather than homocysteine alone.
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B vitamins fail to restore endothelial function despite lowering homocysteine; challenges homocysteine-lowering therapy and extends L-arginine benefit in hyperhomocysteinemia.
K. Sydow (2002) conducted an RCT in Peripheral arterial occlusive disease (PAOD) and hyperhomocyst(e)inemia (n=27). L-arginine or combined B vitamins vs. Placebo was evaluated on Endothelium-dependent, flow-dependent vasodilation (FDD) (p=n.s. for B vitamins). In patients with PAOD and hyperhomocysteinemia, 8 weeks of L-arginine significantly improved flow-dependent vasodilation (10.2% vs placebo 8.9%), whereas B vitamins had no significant effect.
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