The role of arginine in chronic stable angina.




Journal of the American College of Cardiology

Related Monographs

Consumer Data: Angina Arginine
Professional Data: Angina Arginine


Angina, also known as angina pectoris, is a condition that can cause chest pain, ranging from mild to quite severe. Angina occurs when not enough oxygen is able to reach the heart muscle, usually due to a decrease in blood flow. Numerous conditions can affect the blood flow to the heart and thus the amount of oxygen reaching the heart muscle. These conditions include coronary artery disease, coronary artery spasm, irregular rhythms of the heart, infections, anemia, and even a heart attack can cause angina to occur. Generally, angina occurs when extra stress is placed on the heart such as during physical exercise or even at times of stress, anxiety, and depression. This is known as stable angina and is generally due to the presence of coronary artery disease (CAD).

The chest discomfort associated with angina is generally described as a dull pressure, heaviness, squeezing or smothering but can also include sharp pain. The discomfort is usually in the chest and can spread up into the throat, the upper back and into the left shoulder and arm. Sweating, shortness of breath and nausea can also be experienced. As noted, angina can occur at any time but generally is associated with increased physical activity or at times of high emotional stress.

L-arginine is a precursor to endothelium-derived nitric oxide. Arginine's primary function involves the metabolism of protein and nitrogen, as well as the production of a number of important compounds. It also plays a role in maintaining health of the circulatory system. Studies have shown that arginine has clinical benefits in patients with angina. A recent investigation examined the benefits of arginine enriched nutritional bars in chronic, stable angina. For 2 weeks, a group of 36 patients diagnosed with CAD and angina, was given 2 bars daily to eat, half with the active bar and half with a placebo bar. Artery dilation, exercise capacity, and angina onset time were recorded. Although angina onset time was unaffected, artery dilation and exercise time was improved in the active bar group. The authors concluded, "These findings reveal that this arginine-rich medical food, when used as an adjunct to traditional therapy, improves vascular function, exercise capacity and aspects of quality of life in patients with stable angina."1


1. Maxwell AJ. Randomized trial of a medical food for the dietary management of chronic, stable angina. Journal of the American College of Cardiology. Jan 2002;39(1):37-45.