Oral L-arginine improves endothelium-dependent dilation in hypercholesterolemic young adults.

The Journal of clinical investigation
Q1
Apr 1996
Citations:436
Influential Citations:9
Interventional (Human) Studies
92
High RoB
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Methods
27 hypercholesterolemic adults (18 men, 9 women), age approximately 19–40 years, with endothelial dysfunction and elevated LDL-cholesterol; lifelong nonsmokers; not hypertensive or diabetic; some on stable statin therapy; randomized, placebo-controlled, double-blind crossover trial with two 4-week treatment periods separated by a 4-week washout.
Intervention
Oral L-arginine, 7 g three times daily, for 4 weeks; taken as a powder dissolved in water.
Results
Oral L-arginine for 4 weeks significantly improved endothelium-dependent dilation (EDD) of conduit arteries in hypercholesterolemic young adults, increasing EDD from 1.8%±1.3% to 5.7%±3.0% (P<0.001). Placebo produced no significant change. Lipid levels and GTN-mediated dilation remained unchanged. Improvement occurred in about 67% of subjects (18/27). The authors conclude that chronic dietary L-arginine improves large-vessel endothelial function in at-risk individuals and may favorably influence atherogenesis; however, effects were not sustained after cessation and long-term benefits remain to be established.
Limitations
Small sample size (n=27) and short duration (4 weeks per treatment); nitrosoprotein measures available only for a subset (n=11); some participants on stable statin therapy, introducing heterogeneity; results pertain to young adults with endothelial dysfunction and may not generalize to older individuals or established vascular disease; long-term effects and durability of benefit are unknown.

Abstract

In hypercholesterolemic rabbits, oral L-arginine (the substrate for endothelium derived nitric oxide) attenuates endothelial dysfunction and atheroma formation, but the effect in hypercholesterolemic humans is unknown. Using high resolution external ...