Oral L-arginine supplementation in patients with mild arterial hypertension and its effect on plasma level of asymmetric dimethylarginine, L-citruline, L-arginine and antioxidant status.

BACKGROUND: Potential role of L-arginine supplementation as a new effective strategy of improving endothelial function in patients with hypertension is recently under consideration. OBJECTIVE: To evaluate influence of 28-day oral supplementation of L-arginine on plasma level of asymmetric dimethylarginine (ADMA), L-citrulline, L-arginine and total antioxidant status (TAS), in patients with mild arterial hypertension. SUBJECTS AND METHODS: 54 participants (24 women and 30 men) were studied. Ambulatory blood pressure monitoring (ABPM) was used for allotting patients to either healthy control group (19 subjects) or hypertensive treatment group (35 patients). Patients were later randomized to either L-arginine (2 g tid or 4 g tid) or placebo. During 28 days of study on 5 consecutive visits TAS, plasma level of ADMA, L-citrulline, and L-arginine were measured. RESULTS: In patients with mild hypertension treated with L-arginine significant increase in TAS and plasma level of arginine and citrulline was observed. Additionally plasma ADMA concentrations after 28 days of L-arginine supplementation significantly exceeded initial concentrations. CONCLUSIONS: L-arginine supplementation increases plasma arginine, citrulline and TAS in patients with mild arterial hypertension. It confirms the thesis that augmented concentrations of L-arginine stimulate NO biosynthesis which leads to reduction of oxidative stress. Increase of ADMA plasma level after L-arginine supplementation confirms correlation between ADMA and L-arginine.