l-Arginine and B vitamins improve endothelial function in subjects with mild to moderate blood pressure elevation

Abstract

PurposeThe aim of this trial was to investigate the influence of a dietetic product consisting of a unique combination of l-arginine with the vitamins B6, folic acid and B12 (Telcor® Arginin plus) on endothelial dysfunction.MethodsSubjects aged 40–65 years with mild to moderate blood pressure (BP) elevation not treated with anti-hypertensive drugs were randomly assigned to either the dietetic product (n = 40) or a matching placebo (n = 41) for 3 months with open follow-up for a further 3 months. Postprandial change in endothelial function was assessed using the validated reactive hyperaemia index (RHI) at 3 months compared to the study onset (RHI post–pre, visit 3–visit 1; ΔΔRHI). Secondary parameters included BP and plasma homocysteine concentration.ResultsThe primary efficacy analysis revealed superiority of the nutritional intervention over placebo (p = 0.0349) in reducing the deterioration of endothelial function. While in the active group ΔΔRHI increased (0.371 ± 0.122), almost no change could be detected in the placebo group (0.031 ± 0.100), thus demonstrating a significant improvement in vascular function in the intervention group. Moreover, the intervention reduced BP and homocysteine levels. Non-serious adverse events were equally distributed in both groups, and none of the events were assessed as possibly intervention-related by the investigators.ConclusionsThis trial confirmed the effective and safe use of dietary management with l-arginine in combination with B vitamins. The primary efficacy analysis demonstrated a statistically significant superiority of the combination of l-arginine with B vitamins over placebo in improving and restoring impaired endothelial function and lowering BP in patients with mild to moderate blood pressure elevation.

Gut microbiota in obstructive sleep apnea–hypopnea syndrome: disease-related dysbiosis and metabolic comorbidities

“…Arginine levels decreased in our patients with OSAHS, 40–67% of whom suffer from hypertension. Arginine, methionine, HCY, and vitamins influence NO synthesis, eventually affecting the endothelial function that controls vascular homeostasis [34]. Furthermore, diet seemed to play a key role in the synthesis of HCY and NO as well as the composition of the gut microbiota.…”

Amino Acids and Hypertension in Adults

“…Several amino acids interfere with vascular physiology; among them, arginine is well known to have relevant vasogenic properties [49]. Despite a wealth of studies demonstrating the beneficial effects from dietary supplementation with l -arginine including lowering both systolic and diastolic blood pressure levels [50,51], studies focusing on dietary arginine considering only a usual diet, excluding supraphysiological intake through dietary supplementation, did not support any association between this amino acid and blood pressure [11,18]. In middle-aged men participating in the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD), no association was found between dietary arginine and blood pressure levels, regardless of the dietary source (either plant-derived or animal-derived arginine) [11].…”

Amino Acids and Developmental Origins of Hypertension

“…There is some epidemiological evidence of a connection between dietary amino acids and hypertension. Several amino acids, as mentioned above, interfere with BP regulation; among them, dietary arginine supplementation has shown beneficial effects by lowering both systolic and diastolic BP in patients with hypertension [ 63 , 64 ]. However, in studies focusing on a usual diet, excluding supraphysiological intake through dietary supplementation, dietary arginine was not found to be associated with BP [ 65 , 66 ].…”