Computational evaluation of an extra-aortic elastic-wrap applied to simulated aging anisotropic human aorta models

Legerer, Christian; Almsherqi, Zakaria A.; Dokos, Socrates; McLachlan, Craig S.

doi:10.1038/s41598-019-56609-2

Cited by 3 publications

(1 citation statement)

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“…The outcome measures did not always include measures of arterial stiffness or measures of vascular reactivity in order to demonstrate any improvements in stiffness or vascular reactivity. Pre-defined screening for normative population data was carried out; despite this, aging is known to increase resistant systolic blood pressure due to arterial stiffening [ 20 , 21 , 22 ], and it is unknown whether either L-arginine or L-citrulline could reverse arterial stiffening, thereby improving arterial compliance.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Registered Clinical Trial Designs: Comparison of L-Arginine and/or L-Citrulline Interventions for Hypertension

Hillsley,

McLachlan

2024

Pharmaceuticals

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Background: L-Arginine (Arg) is an essential amino acid and a precursor for the synthesis of vascular nitric oxide, while L-Citrulline is a non-essential amino acid substrate for increasing L-arginine. Both L-arginine and L-Citrulline in translational studies may acutely lower the blood pressure. Current meta-analysis for L-arginine or L-Citrulline interventions in blood pressure have identified significant heterogeneity. Clinical trial evidence for L-arginine or L-Citrulline in chronic blood pressure reduction in the general population requires an examination of trial designs, as not all translational studies may have influenced vascular reactivity. Our aims are to explore whether L-arginine and L-citrulline intervention trials in chronic blood pressure consider standardized end points relevant to the general adult populations. Methods: A step-wise search on clinicaltrials.gov, the U.S. Library of Medicine registry for clinical trials, was performed including the following keyword search parameters: “completed” “L-Citrulline” “L-arginine” trial”, and “adults”, involving “blood pressure” reduction as a primary end point in adult humans. Results: Of the forty-four completed trials, only five were included for analysis. Following the careful evaluation of trial design, we observed heterogeneity across participant inclusion criteria (population sample size, age range, sex), interventional design (dosages, duration), and primary outcomes, measured with respect to changes in diastolic or systolic blood pressure. Conclusion: In conclusion, there is a lack of robust trial design evidence to suggest that L-arginine or L-Citrulline, based on current RCTs in the general population, have an overall positive effect on vascular endothelial reactivity and a beneficial chronic blood pressure-lowering effect. Indeed, conclusions drawn from human meta-analysis studies have been heterogenous between studies, which may be attributed to study design heterogeneity, including differences in sample population, age, and blood pressure at the time of entry. Inconsistencies in the study design poses a challenge for systematic reviews and meta-analysis to accurately assess the effect size and impact of L-arginine or L-citrulline on both systolic and diastolic blood pressure.

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Section: Discussionmentioning

confidence: 99%