L-Arginine and B vitamins improve endothelial function in subjects with mild to moderate blood pressure elevation.
OBJECTIVE
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.
, Stuttgart, Germany.
Daniel
D
Menzel
Department of Nephrology and Hypertension Medicine, Hannover Medical School, University of Hannover, Hannover, Germany.
Hermann
H
Haller
Ulm University of Applied Sciences, Ulm, Germany.
Manfred
M
Wilhelm
University Clinic Münster, Albert-Schweitzer-Campus 1, Domagkstr. 3, 48149, Münster, Germany. robenekhorst@gmail.com.
Horst
H
Robenek
D001120:Arginine / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D015331:Cohort Studies; D019587:Dietary Supplements / Q000009:adverse effects; D018450:Disease Progression; D004311:Double-Blind Method; D004730:Endothelium, Vascular / Q000503:physiopathology*; D000075222:Essential Hypertension / Q000150:complications / Q000178:diet therapy / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications / Q000178:diet therapy / Q000503:physiopathology; D006973:Hypertension / Q000150:complications / Q000178:diet therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000150:complications; D058246:Prehypertension / Q000150:complications / Q000178:diet therapy* / Q000503:physiopathology; D012720:Severity of Illness Index; D014655:Vascular Resistance; D014803:Vitamin B Complex / Q000009:adverse effects / Q000627:therapeutic use*
D014803:Vitamin B Complex; D001120:Arginine
Atherosclerosis; B vitamins; Blood pressure; Endothelial function; L-Arginine