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Nutritional therapy for peripheral arterial disease: a double-blind, placebo-controlled, randomized trial of HeartBar®

Division of Research and Development, Cooke Pharma, Inc., Belmont, CA, USA

Barbara E Anderson

Division of Research and Development, Cooke Pharma, Inc., Belmont, CA, USA

John P Cooke

Stanford University, Stanford, CA, USA

We investigated the clinical effects of a food bar enriched with l-arginine and a combination of other nutrients known to enhance the activity of endothelium-derived nitric oxide (EDNO) in individuals with claudication from atherosclerotic peripheral arterial disease. The study was a 2-week, double-blind, placebo-controlled trial of subjects randomized to three groups (two active bars, one active and one placebo bar, and two placebo bars per day) followed by an 8-week open-label period. Subjects (n = 41) were outpatient volunteers with intermittent claudication. Pain-free and total walking distances were measured by variable-grade, treadmill exercise testing. Quality of life was assessed using the Medical Outcome Survey (SF-36). After 2 weeks of treatment, the pain-free walking distance increased 66% while the total walking distance increased 23% in the group taking two active bars/day. The general and emotional/social functioning components of the SF-36 also improved. These effects were not observed in the one active bar/day and placebo groups. The effects were maintained after 10 weeks and, in addition, an improvement in walking distance was observed in the group taking one active bar. These findings reveal that use of a nutrient bar designed to enhance EDNO activity improves pain-free and total walking distance as well as quality of life in individuals with intermittent claudication.

Key Words: antioxidant • endothelium • intermittent claudication • l-arginine • nitric oxide

Vascular Medicine, Vol. 5, No. 1, 11-19 (2000)
DOI: 10.1177/1358836X0000500103


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