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Effect of L-Arginine Supplementation on Blood Pressure in Adults: A Systematic Review and Dose-Response Meta-Analysis of Randomized Clinical Trials Publisher Pubmed



Shiraseb F1 ; Asbaghi O2 ; Bagheri R3 ; Wong A4 ; Figueroa A5 ; Mirzaei K1
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Authors Affiliations
  1. 1. Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
  2. 2. Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  3. 3. Department of Exercise Physiology, University of Isfahan, Isfahan, Iran
  4. 4. Department of Health and Human Performance, Marymount University, Arlington, VA, United States
  5. 5. Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, United States

Source: Advances in Nutrition Published:2022


Abstract

A decade-old meta-analytic work indicated that l-arginine supplementation might have a blood pressure (BP)-lowering effect in different populations. However, several relevant investigations have emerged in the last 10 y, and an up-to-date systematic review and meta-analysis on this topic is currently lacking. Therefore, we aimed to examine the impact of l-arginine supplementation on BP by conducting a systematic review and dose-response meta-analysis of randomized placebo-controlled clinical trials (RCTs). We searched online databases using relevant keywords up to April 2021 to identify RCTs using oral l-arginine on systolic BP (SBP) and diastolic BP (DBP) in adults. Inclusion criteria were adult participants and an intervention duration ≥4 d. Exclusion criteria were the use of l-arginine infusion and acute interventions. A random-effects model was used to estimate the weighted mean difference (WMD) and 95% CI. Twenty-two RCTs with 30 effect sizes were included in this meta-analysis. The pooled analysis demonstrated significant decreases in SBP (WMD = -6.40 mmHg; 95% CI: -8.74, -4.05; P < 0.001) and DBP (WMD = -2.64 mmHg; 95% CI: -3.94, -1.40; P < 0.001) after l-arginine supplementation. Subgroup analysis showed significant reductions in SBP and DBP regardless of baseline BP category (normotensive, hypertensive), study duration (≤24 d, >24 d), sex (female, male), health status (healthy, unhealthy), and BMI (normal, overweight, obese). No significant changes were observed with dosages >9 g/d, trial duration >24 d, or in obese individuals. l-Arginine supplementation also appears to decrease DBP more effectively in females than in males. Moreover, meta-regression analysis for DBP demonstrated a significant relation between the dose of l-arginine intake and changes in DBP (P = 0.020). In the nonlinear dose-response analysis, the effective dosage of l-arginine supplementation was detected to be ≥4 g/d for SBP (P = 0.034), independent of trial duration. Overall, l-arginine supplementation may be effective for decreasing BP. This study was registered at PROSPERO as CRD42021242772. © 2021 The Author(s). Published by Oxford University Press on behalf of the American Society for Nutrition.
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