Front Cardiovasc Med 2022 Apr 12;9:868521. L-Arginine Improves Cognitive Impairment in Hypertensive Frail Older Adults Pasquale Mone 1 2 3, Antonella Pansini 2, Stanislovas S Jankauskas 1, Fahimeh Varzideh 1, Urna Kansakar 1, Angela Lombardi 1, Valentina Trimarco 4, Salvatore Frullone 2, Gaetano Santulli 1 4
Affiliations 1 Department of Medicine, Albert Einstein College of Medicine, New York, NY, United States. 2 Azienda Sanitaria Locale (ASL) Avellino, Avellino, Italy. 3 Campania University, Naples, Italy. 4 University of Naples “Federico II”, Naples, Italy.
Abstract Cognitive impairment is a prevailing event in hypertensive patients and in frail older adults. Endothelial dysfunction has been shown to underlie both hypertension and cognitive dysfunction. Our hypothesis is that L-Arginine, which is known to ameliorate endothelial dysfunction, could counteract cognitive impairment in a high-risk population of hypertensive frail older adults. We designed a clinical trial to verify the effects of 4-weeks oral supplementation of L-Arginine on global cognitive function of hypertensive frail older patients. The study was successfully completed by 35 frail hypertensive elderly patients assigned to L-Arginine and 37 assigned to placebo. At follow-up, we found a significant difference in the Montreal Cognitive Assessment (MoCA) test score between the L-Arginine treated group and placebo (p: 0.0178). Moreover, we demonstrated that L-Arginine significantly attenuates Angiotensin II-induced mitochondrial oxidative stress in human endothelial cells. In conclusion, our findings indicate for the first time that oral L-Arginine supplementation significantly improves cognitive impairment in frail hypertensive older adults.
Clinical trial registration: www.ClinicalTrials .gov, identifier: NCT04962841.
Keywords: L-Arg; L-Arginine; cardiac rehabilitation; cognitive impairment; endothelial (dys)function; frail adults; frailty.
Conflict of interest statement The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.