Methylarginine levels and their impact on vascular aging: a systematic review

Vascular aging is a multifactorial process characterized by structural and functional changes that compromise endothelial homeostasis and increase the risk of cardiovascular disease. Among the factors involved in this process, methylarginines, such as asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and NG-monomethyl-L-arginine (L-NMMA), stand out. These negatively modulate nitric oxide (NO) bioavailability, compromising endothelial function. This systematic review aimed to investigate the relationship between vascular aging and methylarginine levels, considering their influence on endothelial dysfunction and its impact on human health. The systematic search was conducted in scientific databases, resulting in the inclusion of four studies: three observational studies in humans and one experimental study in vitro. The findings demonstrated that elevated levels of ADMA, SDMA, and L-NMMA are associated with the progression of endothelial dysfunction, increased cardiovascular risk, and cognitive impairment in the elderly. The in vitro study reinforced this evidence by demonstrating that increasing concentrations of ADMA accelerate endothelial cell senescence, reduce telomerase activity, and decrease NO production. Interpretation of the results should consider the methodological limitations of the included studies, but the findings reinforce the role of methylarginines as potential biomarkers of vascular aging and highlight the need for further investigations exploring therapeutic strategies to minimize their deleterious effects.