Arginine is the substrate for nitric oxide synthesis, which is pivotal to vascular homeostasis and linked to the insulin response, it has long been posited that supplemental arginine could benefit cardiometabolic health. So administration of arginine can be effective in the treatment of hypertension as well?
arginine is a key player in a set of physiological functions that interact to maintain vascular health and homeostasis.Because the substrate for NOS in the formation of the potent vasodilator NO, arginine is essential in the NO pathway.
see this link https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2728371/
if eNOS enzyme is dysfunctional in hypertension, substrate addition will not efficiently work to increase NO production. It may lower the blood pressure by ~2-5mm Hg, but not significantly. I could not find any results from the clinical trials, probably they failed to show efficacy.
In few words: in experimental models it decreased BP level, but in clinical studies did not.
The endothelial cells of our vasculature protect us against atherosclerosis and thrombosis. A major weapon of endothelial cells to fight vascular disease is endothelial nitric oxide synthase (eNOS), an enzyme that generates the vasoprotective molecule nitric oxide (NO·). However, many of us unintentionally mistreat our endothelial cells. We expose them to risk factors such as cigarette smoke, high blood pressure, high glucose, or high lipids. Despite this abuse, our endothelium bears with us for some time, tries to maintain NO· production, and preserves vascular protection. However, the risk factors lead to excess production of superoxide (O2·−; ie, they produce oxidative stress). O2·− reacts with NO· to form peroxynitrite, and vascular protection slowly vanishes. But that is only the beginning of the calamity. Our eNOS now enters into a vicious biochemical cycle. It changes its enzymology, starts making peroxynitrite (ONOO−) itself, and eventually becomes an enzyme that generates only O2 [Circulation. 2006;113:1708–1714]
Ruslan Rafikov Thanks for your contribution.
Do you have personal clinical experiences in this regard?
Yuriy M. Sirenko Thank you for your contribution.
During my clinical experience (indeed limited so far) I found several cases of patients with high BP who after oral arginine supplementation did show a significant lowering of the average values, in some cases allowing the reduction of antihypertensive drugs already in therapy.
Please take a look at the following RG link and a PDF attachment.
Article The Effects of Oral L-Arginine and L-Citrulline Supplementat...
As pulmonary arterial hypertension (PAH) patient I participated in a trial using very high doses of l-arginine (3x daily 3g which was 1g/10kg body mass) in PAH, called PHAST (about 2004). This trial was stopped premature because of no effect (as was said) and it was not published. In contrast to most participants I felt an effect a could of blood parameters improved as well as 6min walk distance. This might have been because my PAH is based on an ACVRL1 mutation and not like in most familial PAH patients on a BMPR2 mutation, who knows.
An interesting side observation:
I've had chronic sinusitis all my life, but using this high dose l-arginine, all sinusits issues were gone. And end of 2005 I stopped l-arginin and started sildenafil for PAH. This is also involved in the NO pathway and cGMP.
Until today I've never had any real sinusitis anymore.
Doing some research, I read, that in the sinusses is the highest NO concentration in the body. I assume, that it could make sense as a natural anti-biotic in this critical cavities. Could this make sense?
In PAH it is well established, that a lack of NO-synthase is leading to low eNOS. And that thus high arginine uptake won't help to solve the problem. Is it the same for systemic high BP?
Just wondering.
Ralf Schmiedel Your observation is very interesting and I am sure it definitely deserves to be deepened. It should be investigated much more , I believe there are strong assumptions to do it. Thank you for your helpful intervention.