OBJECTIVE: TO examine the role of L-arginine in the management of cardiovas
cular diseases.
DATA SOURCES: A MEDLINE search (1966-April 2000) of review articles, using
the search terms arginine, nitric oxide, and cardiovascular diseases, was c
onducted. After reviewing these articles, primary studies using the search
terms arginine, hypercholesterolemia, hypertension, diabetes, smoking, isch
emic heart disease, and heart failure were reviewed.
STUDY SELECTION: English-language human studies were selected and evaluated
based on quality of review.
DATA SYNTHESIS: Small-scale studies have demonstrated that intravenous L-ar
ginine augments endothelial function by enhancing vasodilation and reducing
monocyte adhesion. Oral supplementation demonstrated similar effects as we
ll as improvement of exercise ability in patients with cardiovascular disea
ses.
CONCLUSIONS: L-arginine improves the management of multiple cardiovascular
diseases. However, most published human studies are small. Before therapy c
an be routinely recommended, larger, well-designed studies are required to
confirm its effect.