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

Eur J Nutr. 2018 Mar;57(2):557-568. doi: 10.1007/s00394-016-1342-6. Epub 2016 Nov 5.

Abstract

Purpose: The 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.

Methods: Subjects 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.

Results: The 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.

Conclusions: This 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.

Keywords: Atherosclerosis; B vitamins; Blood pressure; Endothelial function; L-Arginine.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Arginine / adverse effects
  • Arginine / therapeutic use*
  • Blood Pressure
  • Blood Pressure Monitoring, Ambulatory
  • Body Mass Index
  • Cohort Studies
  • Dietary Supplements* / adverse effects
  • Disease Progression
  • Double-Blind Method
  • Endothelium, Vascular / physiopathology*
  • Essential Hypertension / complications
  • Essential Hypertension / diet therapy
  • Essential Hypertension / physiopathology
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperhomocysteinemia / complications
  • Hyperhomocysteinemia / diet therapy
  • Hyperhomocysteinemia / physiopathology
  • Hypertension / complications
  • Hypertension / diet therapy*
  • Hypertension / physiopathology
  • Male
  • Middle Aged
  • Overweight / complications
  • Prehypertension / complications
  • Prehypertension / diet therapy*
  • Prehypertension / physiopathology
  • Severity of Illness Index
  • Vascular Resistance
  • Vitamin B Complex / adverse effects
  • Vitamin B Complex / therapeutic use*

Substances

  • Vitamin B Complex
  • Arginine