Effects of Nutritional Supplements on Vascular Function: A Narrative Review

Area of Science:

• Cardiovascular Science
• Nutritional Science
• Aging Research

Background:

• Vascular aging contributes to cardiovascular risk through endothelial dysfunction, oxidative stress, and arterial stiffness.
• Nutritional supplements are being investigated for their potential to modulate these aging mechanisms.
• Endothelial glycocalyx alterations are a key feature of vascular aging.

Purpose of the Study:

• To review and critically evaluate evidence on nutritional supplements affecting endothelial function and vascular health.
• To examine proposed mechanisms of action and available preclinical/clinical data.
• To identify limitations in current research on supplements for vascular health.

Main Methods:

• Narrative review of scientific literature.
• Analysis of supplements targeting nitric oxide biology, polyphenols, mitochondrial function, and endothelial glycocalyx.
• Evaluation of studies on L-arginine/L-citrulline, cocoa flavan-3-ols, grape polyphenols, CoQ10, MitoQ, and others.

Main Results:

• Improvements noted in surrogate vascular endpoints like flow-mediated dilation, pulse wave velocity, and blood pressure.
• Significant heterogeneity and variable effect sizes observed across studies.
• Limited evidence exists for supplements reducing major cardiovascular events or mortality.

Conclusions:

• Several nutritional supplements show potential in improving surrogate markers of vascular function.
• Robust evidence for reducing clinical cardiovascular outcomes is currently lacking.
• Future research requires large, long-term RCTs with standardized formulations and clinically relevant outcomes.