L-Arginine Improves Cognitive Impairment in Hypertensive Frail Older Adults

Mone, Pasquale; Pansini, Antonella; Jankauskas, Stanislovas S.; Varzideh, Fahimeh; Kansakar, Urna; Lombardi, Angela; Trimarco, Valentina; Frullone, Salvatore; Santulli, Gaetano

doi:10.3389/fcvm.2022.868521

Cited by 12 publications

(7 citation statements)

References 77 publications

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“…This dose has been chosen based on a previous study (Gambardella et al, 2021a) in which we had verified that this regimen was safe and effective in ameliorating oxidative metabolism of water polo players. The taste is fully buffered by the addition of anhydrous citric acid and sucrose (Fiorentino et al, 2021;Mone et al, 2022d). Hence, there were no differences in appearance, taste, or smell, between placebo and treatment.…”

Section: Methodsmentioning

confidence: 99%

L-Arginine Enhances the Effects of Cardiac Rehabilitation on Physical Performance: New Insights for Managing Cardiovascular Patients During the COVID-19 Pandemic

Mone

Izzo

Marazzi

et al. 2022

J Pharmacol Exp Ther

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Cardiac rehabilitation (CR) following acute myocardial infarction (AMI) improves physical capacities and decreases hospitalizations and cardiovascular mortality. L-Arginine is the substrate used by nitric oxide (NO) synthase (NOS) to generate NO and it has been shown to exert its beneficial effects on endothelium driving vasodilatation, reducing inflammation, and ameliorating physical function. We hypothesized that L-Arginine could enhance physical capacities in patients who underwent CR after AMI. We designed a study aimed to assess the effects of L-arginine administration on the physical capacity of patients who underwent coronary revascularization after AMI. The trial was carried out amid the COVID-19 pandemic. Patients were assigned, with a 2:1 ratio, to add to their standard therapy 1 bottle containing 1.66 g of L-arginine or 1 bottle of identical aspect apart from not containing L-arginine, twice a day orally for 3 weeks. Patients performed a 6minute walking test (6MWT) and were assessed their Borg modified 0-10 rating of perceived exertion (BRPE) before starting and at the end of the treatment. Seventy-five patients receiving L-Arginine, and thirty-five receiving placebo successfully completed the study. The 6MWT distance increased significantly in the L-Arginine group compared to both baseline and placebo (p<0.0001).Additionally, we observed a significant improvement in the BRPE in patients treated with Larginine but not in the placebo group. Taken together, our data indicate that L-arginine potentiates the response to CR, independently of age, sex, baseline functional capacity, and comorbid conditions.

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Section: Methodsmentioning

confidence: 99%

L-Arginine Enhances the Effects of Cardiac Rehabilitation on Physical Performance: New Insights for Managing Cardiovascular Patients During the COVID-19 Pandemic

Mone

Izzo

Marazzi

et al. 2022

J Pharmacol Exp Ther

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“…Studies suggested that endothelial dysfunction was involved in both hypertension and cognitive impairment (10,11). Several medications, such as L-arginine, empagliflozin, choline, metformin, and others, have been found to improve endothelial function and may therefore be beneficial in enhancing cognitive function (12,(37)(38)(39).…”

Section: Discussionmentioning

confidence: 99%

Effect of blood pressure on mortality in patients with cognitive impairment: a prospective cohort study

Shang,

Wang,

Wei

et al. 2023

Front. Cardiovasc. Med.

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BackgroundCognitive impairment is a prevalent condition that substantially elevates mortality rates among the elderly. The impact of hypertension on mortality in older adults with cognitive impairment is a subject of contention. This study aims to examine the influence of hypertension on both all-cause and CVD-specific mortality in elderly individuals experiencing cognitive impairment within a prospective cohort.MethodsThis study encompassed 2,925 participants (weighted 53,086,905) aged 60 years or older from National Health and Nutrition Examination Survey (NHANES) spanning 2011–2014. Incidence of all-cause and CVD-specific mortality was ascertained through linkage with National Death Index records until 31 December 2019. Survival was performed employing the Kaplan–Meier method. Hazard ratios (HRs) were calculated via Cox proportional hazards regression models.ResultsOver the follow-up period of up to 9.17 years [with a median (IQR) time to death of 6.58 years], equivalent to 18,731.56 (weighted 3.46 × 108) person-years, there were a total of 576 recorded deaths. Participants with CI exhibited a 1.96-fold higher risk of all-cause mortality (95% CI: 1.55–2.49; p < 0.01) and a 2.8-fold higher risk of CVD-specific mortality (95% CI: 1.83–4.29; p < 0.01) in comparison to participants without CI. Among participants with CI, concurrent hypertension comorbidity was linked to a 2.73-fold elevated risk of all-cause mortality (95% CI: 1.78–4.17; p < 0.01) and a 5.3-fold elevated risk of CVD-specific mortality (95% CI: 2.54–11.04; p < 0.01). Further stratified analyses revealed that the combined effects of hypertension and CI on all-cause and CVD-specific mortality were more pronounced in participants aged 60–69 years compared to those aged 70–80 years (p for interaction <0.01). The primary findings exhibited resilience across a series of sensitivity analyses.ConclusionsParticipants with CI exhibited a markedly elevated risk of all-cause and CVD-specific mortality when coexisting with hypertension. Appropriate management of hypertension in patients with CI may be helpful in reducing the excess risk of death.

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“…A diagnosis of frailty status was made according to the Fried Criteria, as we previously reported ( 19 , 41 ):…”

Section: Methodsmentioning

confidence: 99%

Hyperglycemia and Physical Impairment in Frail Hypertensive Older Adults

et al. 2022

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BackgroundFrailty is a multidimensional condition typical of elders. Frail older adults have a high risk of functional decline, hospitalization, and mortality. Hypertension is one of the most common comorbidities in elders. Hyperglycemia (HG) is frequently observed in frail older adults, and represents an independent predictor of worst outcomes, with or without diabetes mellitus (DM). We aimed at investigating the impact of HG on physical impairment in frailty.MethodsWe studied consecutive older adults with frailty and hypertension at the ASL (local health unit of the Italian Ministry of Health) of Avellino, Italy, from March 2021 to September 2021. Exclusion criteria were: age <65 years, no frailty, no hypertension, left ventricular ejection fraction <25%, previous myocardial infarction, previous primary percutaneous coronary intervention and/or coronary artery bypass grafting. Blood glucose, Hb1Ac, and creatinine were measured in all patients. Physical frailty was assessed applying the Fried Criteria; we performed a 5-meter gait speed (5mGS) test in all patients.Results149 frail hypertensive older adults were enrolled in the study, of which 82 had normoglycemia (NG), and 67 had HG. We observed a significantly slower 5mGS in the HG group compared to the NG group (0.52 ± 0.1 vs. 0.69 ± 0.06; p<0.001). Moreover, we found a strong and significant correlation between 5mGS and glycemia (r: 0.833; p<0.001). A multivariable linear regression analysis using 5mGS as a dependent variable revealed a significant independent association with glycemia (p<0.001) after adjusting for likely confounders.ConclusionsHG drives physical impairment in frail hypertensive older adults independently of DM.

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L-Arginine Improves Cognitive Impairment in Hypertensive Frail Older Adults

Cited by 12 publications

References 77 publications

L-Arginine Enhances the Effects of Cardiac Rehabilitation on Physical Performance: New Insights for Managing Cardiovascular Patients During the COVID-19 Pandemic

L-Arginine Enhances the Effects of Cardiac Rehabilitation on Physical Performance: New Insights for Managing Cardiovascular Patients During the COVID-19 Pandemic

Effect of blood pressure on mortality in patients with cognitive impairment: a prospective cohort study

Hyperglycemia and Physical Impairment in Frail Hypertensive Older Adults

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