Evidence supporting the use of: Arginine
For the health condition: Angina

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Arginine (L-arginine) is an amino acid that serves as a precursor for nitric oxide (NO), a molecule that relaxes blood vessels and enhances blood flow. The rationale behind using arginine for angina (chest pain due to insufficient blood flow to the heart) is that increased NO production may help improve coronary circulation and reduce angina symptoms. Several small clinical studies have explored this possibility. For example, early trials found that oral or intravenous L-arginine could improve exercise tolerance and decrease angina symptoms in patients with stable angina, likely due to improved endothelial function and vasodilation.

However, the evidence is inconsistent. Some larger and more recent trials have failed to show a significant benefit of L-arginine supplementation for angina or cardiovascular outcomes. Notably, the VINTAGE MI trial (2006) found no improvement in vascular stiffness or ejection fraction in patients with acute myocardial infarction, and there was a signal for increased mortality in the arginine group. As a result, enthusiasm for arginine as a therapy for angina has waned, and it is not included in major clinical guidelines. The overall evidence is limited and sometimes conflicting, supporting at best a modest effect in select populations. Therefore, arginine is considered to have scientific rationale for use based on its biochemistry and some early studies, but the quality and consistency of clinical evidence is low (rated 2/5).

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