Pycnogenol, a standardized extract from the bark of the French maritime pine (Pinus pinaster), has been studied for various cardiovascular benefits, including its potential role in supporting individuals with angina pectoris. The scientific evidence supporting its use in this context is limited but present. A small number of clinical trials and pilot studies have suggested that Pycnogenol may improve endothelial function, reduce oxidative stress, and enhance nitric oxide production, all of which could theoretically improve blood flow and reduce symptoms of angina.

One pilot study (Belcaro et al., 2012) found that supplementation with Pycnogenol (in combination with L-arginine) improved exercise capacity and reduced symptoms in patients with stable angina compared to controls. The proposed mechanism involves improved endothelial function and vasodilation, which may help to increase myocardial oxygen supply. However, these studies are generally small in sample size, sometimes open-label, and often combine Pycnogenol with other supplements, making it difficult to attribute effects solely to Pycnogenol.

There are no large-scale, high-quality randomized controlled trials establishing Pycnogenol as a standard treatment for angina. Therefore, while there is some scientific evidence suggesting a possible benefit, it is preliminary and not sufficient to warrant strong clinical recommendations. Pycnogenol should not replace conventional angina therapies, but may be considered as an adjunct under medical supervision.