Title

Effect of L-Arginine and Pycnogenol on Light to Moderate Hypertension and Endothelial Function
Effect of a Dietary Supplement on Endothelial Function in Volunteers With Light to Moderate Hypertension - a Randomised, Double-blind, Placebo Controlled Cross-over Study
  • Phase

    N/A
  • Study Type

    Interventional
  • Study Participants

    25
The effect of a combination product (Verum ) with L-arginine, Pycnogenol, vitamin K2, R-(+)-alpha-lipoic acid and vitamins B6, B12 and folic acid is investigated in a double blind placebo-controlled cross-over study. Volunteers with hypertension and hyperhomocysteinemia are randomly assigned to the dietary supplement or placebo.
25 patients were included in the trial. Intervention period was 4 weeks with 2 months wash out phase. The screening visit of all volunteers before study start included volunteer information, signature of informed consent, anamnesis, medical history, ECG and blood routine analysis.

Efficacy parameters were measured at visit 1, 2, 3, and 4. Endothelial function and postprandial endothelial Reaction was tested using EndoPAT (validated diagnosis tool). Blood pressure was measured by volunteers over a period of 7 days before each visit. As additional parameters homocysteine and ADMA (assymmetric dimethyl arginine) were determed. For safety evaluation AEs (Adverse Events), CC (compliance control), tolerability, blood routine parameters and vital signs were assessed.
Study Started
Oct 31
2014
Primary Completion
Aug 31
2015
Study Completion
Aug 31
2015
Results Posted
May 02
2016
Estimate
Last Update
May 02
2016
Estimate

Dietary Supplement Verum

2400 mg L-arginine, 80 mg Pycnogenol, 45µg vitamine K2, 10 mg R (+) alpha lipoic acid, 8 mg vitamine B6, 500 µg vitamine B12, and 600 mg folic acid.

Dietary Supplement Placebo

corn starch

Verum Active Comparator

2 times 2 tablets a day for 4 weeks.

  • Dietary Supplement Verum

Placebo Placebo Comparator

2 times 2 tablets a day which cornstarch. Tablets look identical like verum tablets.

Criteria

Inclusion Criteria:

borderline blood pressure (systolic 130-149)
homocystein level >10µmol/l

Exclusion Criteria:

e.g.

BMI <20kg/m2 and >32kg/m2
use of antihypertensives, anticoagulants, and statins
cardiovascular diseases e.g. stroke, myocardial infarction
use of L-arginine and other dietary supplements

Summary

Verum

Placebo

All Events

Event Type Organ System Event Term Verum Placebo

Change in Endothelial Function Between the Visit at Start of Supplementation Phase and the Visit on the Final Day of the 4 Week Supplementation Phase (Delta "lnRHI")

Endothelial function was determined with the EndoPAT™ method (non-invasive Peripheral Aterial Tonometry) using a reactive hyperemia procedure. The outcome measure is the change in endothelial function between the visit at start of the supplementation phase and the visit on the final day of the 4 week supplementation phase. The endothelial function is determined as the natural log of the Reactive Hyperemia Index ("lnRHI") which is the post-to-pre occlusion peripheral arterial tonometry signal ratio in the occluded side, relative to the same ratio in the control side, corrected for baseline vascular tone of the occluded side. Normal lnRHI > 0.51, Abnormal lnRHI < 0.51

Verum

0.07
Delta lnRHI [Index] (Mean)
95% Confidence Interval: -0.065 to 0.205

Placebo

-0.052
Delta lnRHI [Index] (Mean)
95% Confidence Interval: -0.163 to 0.06

Mean of Blood Pressure Measured Daily at the Last 7 Days of the 4 Week Intervention Period.

The mean of daily systolic and diastolic blood pressure measured daily at the last 7 days of the 4 week intervention period. Measurements were performed by subjects at home and were taken on the left arm, after at least 10 minutes of rest, in a sitting position.

Verum

diastolic reading

82.2
mmHg (Mean)
95% Confidence Interval: 79.8 to 84.6

systolic reading

132.8
mmHg (Mean)
95% Confidence Interval: 129.1 to 136.6

Placebo

diastolic reading

83.5
mmHg (Mean)
95% Confidence Interval: 81.7 to 85.3

systolic reading

133.2
mmHg (Mean)
95% Confidence Interval: 130.4 to 136.1

Homocystein Level Determined on the Final Day of the 4 Week Intervention Period.

Homocystein level in µmol/l was determined on the final day of the 4 week intervention period. The first supplementation period started at visit one and lasted for 4 weeks. It was followed by a wash out phase of 8 weeks and subsequently by a second supplementation phase of 4 weeks (cross-over design)

Verum

9.1
μmol/l (Mean)
95% Confidence Interval: 8.3 to 9.9

Placebo

11.95
μmol/l (Mean)
95% Confidence Interval: 11.19 to 12.72

Asymmetric Dimethyl Arginine (ADMA) Level Determined on the Final Day of the 4 Week Intervention Period.

ADMA (asymmetric dimethyl arginine) was determined on the final day of the 4 week intervention period. Samples were analyzed batch wise using an enzymatic test

Verum

0.638
µmol/l (Mean)
95% Confidence Interval: 0.594 to 0.682

Placebo

0.632
µmol/l (Mean)
95% Confidence Interval: 0.596 to 0.668

Glycated Hemoglobin (HbA1c) Determined on the Final Day of the 4 Week Intervention Period.

Glycated hemoglobin (HbA1c) as percentage of total hemoglobin was determined on the final day of the 4 week intervention period.

Verum

5.37
percentage of total hemoglobin (Mean)
95% Confidence Interval: 5.2 to 5.54

Placebo

5.34
percentage of total hemoglobin (Mean)
95% Confidence Interval: 5.19 to 5.5

Change in Prothrombin Time Between the Visit at Start of Supplementation Phase and the Visit on the Final Day of the 4 Week Supplementation Phase

Prothrombin Time was assessed at the visit at start of the supplementation phase and the visit at the end of the 4 week supplementation phase. Blood coagulability is expressed in units of Quick value. In this case, the measured prothrombin time is expressed in relation to the coagulation time of a healthy person. The value obtained is the "percentage of the standard Quick value". In a person not receiving oral anticoagulation the "normal" Quick value is between 70 and 100%. The longer the patient's coagulation time, the lower the Quick value

Verum

2.0
Percentage of the standard Quick value (Mean)
95% Confidence Interval: -0.54 to 4.54

Placebo

1.5
Percentage of the standard Quick value (Mean)
95% Confidence Interval: -1.31 to 4.31

Total

25
Participants

Age, Categorical

Region of Enrollment

Sex: Female, Male

Overall Study

First Verum, Then Placebo

First Placebo, Then Verum