Mone Pasquale, Pansini Antonella, Jankauskas Stanislovas S, Varzideh Fahimeh, Kansakar Urna, Lombardi Angela, Trimarco Valentina, Frullone Salvatore, Santulli Gaetano
Department of Medicine, Albert Einstein College of Medicine, New York, NY, United States.
Azienda Sanitaria Locale (ASL) Avellino, Avellino, Italy.
Front Cardiovasc Med. 2022 Apr 12;9:868521. doi: 10.3389/fcvm.2022.868521. eCollection 2022.
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 (: 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.
www.ClinicalTrials.gov, identifier: NCT04962841.
认知障碍在高血压患者和体弱的老年人中是一种普遍现象。内皮功能障碍已被证明是高血压和认知功能障碍的共同基础。我们的假设是，已知可改善内皮功能障碍的L-精氨酸能够抵消高血压体弱老年人这一高危人群的认知障碍。我们设计了一项临床试验，以验证为期4周口服补充L-精氨酸对高血压体弱老年患者整体认知功能的影响。该研究由35名分配到L-精氨酸组和37名分配到安慰剂组的体弱高血压老年患者成功完成。在随访时，我们发现L-精氨酸治疗组和安慰剂组之间的蒙特利尔认知评估（MoCA）测试得分存在显著差异（P = 0.0178）。此外，我们证明L-精氨酸可显著减轻血管紧张素II诱导的人内皮细胞线粒体氧化应激。总之，我们的研究结果首次表明，口服补充L-精氨酸可显著改善体弱高血压老年人的认知障碍。
