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This therapeutic combination consists of estrogen therapy and L-arginine, investigated by the National Heart, Lung, and Blood Institute (NHLBI) for its vascular and metabolic effects in postmenopausal women with hypercholesterolemia. Estrogen is a hormone that stimulates the synthesis and activity of nitric oxide synthase (NOS) in endothelial cells, thereby increasing the bioactivity of nitric oxide (NO) in the vasculature. L-arginine serves as the natural substrate for NOS. The combination is intended to produce additive vasomotor, hemostatic, and anti-inflammatory effects by maximizing the production and bioactivity of nitric oxide, which is often impaired in the setting of elevated cholesterol and menopause. The combination was evaluated in a Phase 2 crossover clinical trial to assess improvements in endothelial function and metabolic markers.
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