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(Hypertension. 2004;44:e1.)
© 2004 American Heart Association, Inc.

Hypertension Electronic Pages

Letter to the Editor

Evidence Supporting a Beneficial Role for Long-Term L-Arginine Supplementation in High-Risk Pregnancies

Departamento de Obstetricia/Ginecología, Facultad de Medicina Pontificia Universidad Católica, Santiago, Chile

Gloria Valdés

Departamento de Nefrología, Facultad de Medicina Pontificia Universidad Católica, Santiago, Chile

Mary Carmen Romanik; M. Soledad Reyes

Departamento de Obstetricia/Ginecología, Facultad de Medicina Pontificia Universidad Católica, Santiago, Chile

Letters to the Editor will be published, if suitable, as space permits. They should not exceed 1000 words (typed double-spaced) in length and may be subject to editing or abridgment.

An extract of the first 250 words of the full text is provided, because this article has no abstract.

To the Editor:

In the March issue of Hypertension Noris et al describe that preeclamptic women have decreased placental villi L-arginine concentration and overexpression of arginase II.¹ In February, Alexander et al reported that supplementing L-arginine in pregnant rats with reduced uterine perfusion decreased blood pressure, concomitantly increasing serum L-arginine levels and urinary nitrite/nitrate.² Both reports highlight the role of the L-arginine-nitric oxide (NO) pathway in determining normal and preeclamptic pregnancies and sustain the potential benefit of L-arginine supplementation in women at risk of preeclampsia. Although L-arginine has been given acutely to preeclamptic women, there is no concordance about its benefits.^3,4 We wish to underscore the benefits of this intervention with our experience with chronic long-term oral L-arginine supplementation in women at risk of placentation-related disorders.

Seventeen women with bilateral notching and high uterine artery resistance in transvaginal ultrasounds performed 2 weeks apart (–2 and 0 weeks) were included. Endothelial function was also assessed by high-resolution ultrasound of the brachial artery. Of the 15 multiparas, 3 had presented preeclampsia associated with stillbirth in 2, 5 had unexplained recurrent abortions, 2 had isolated spontaneous abortions, and 1 had a premature delivery of ischemic origin. None presented thrombophilias. L-Arginine supplementation (0.1 g/kg per day PO; Smartbasics, San Francisco, Calif) was started at 10.1±0.9 (SEM) weeks of gestation (week 0), and continued until delivery. After 2 weeks on L-arginine, the women’s mean arterial pressure and uterine artery resistance index decreased (75±2 versus 82±3 and . . . [Full Text of this Article]

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