Synopsis

Source of validity: Scientific
Rating (out of 5): 2

L-citrulline is a nonessential amino acid that plays a role in the urea cycle and is a precursor to L-arginine, which in turn is a substrate for nitric oxide (NO) synthesis. Nitric oxide is important for vascular health as it induces vasodilation, which can improve blood flow. The rationale for using L-citrulline in angina (chest pain due to reduced blood flow to the heart) is based on its ability to increase NO production, potentially improving coronary blood flow and alleviating symptoms.

Several small clinical studies and preclinical investigations have explored L-citrulline supplementation in cardiovascular conditions, including angina. Evidence suggests that L-citrulline can increase plasma L-arginine levels more effectively than direct L-arginine supplementation, leading to improved NO production and endothelial function. Some small-scale trials have demonstrated improvements in exercise capacity and reductions in blood pressure, factors that could benefit individuals with angina. However, the number of rigorous, large-scale clinical trials specifically evaluating L-citrulline for angina is limited. Most available studies have small sample sizes, and some are focused on related cardiovascular risk factors rather than angina itself.

Overall, while there is a plausible scientific mechanism and preliminary human data suggesting potential benefit, the evidence remains limited and not robust enough for strong clinical recommendations. Thus, the evidence level is rated 2 out of 5, reflecting weak-to-moderate support predominantly based on mechanistic plausibility and early clinical data rather than large, definitive trials.

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