Methods of stimulation of nitric oxide production in patients with peripheral occlusive arterial disease considering improvement of endothelial dysfunction

The open randomized trial meeting ICH GCP criteria included 5 groups of patients with peripheral occlusive arterial disease stage IIA-III according to the Fontaine classification in modification by Pokrovsky. The first group was given 5mg of nebivolol qd po, the second was given perindopril 5, 10 mg qd po, the third - L-arginine 500mg bid po during 30 days, patients in the 4th group underwent a short-course intermittent pneumocompression (7 procedures). Patients in the 5th group (control group) underwent traditional conservative therapy (dextranes, antiagregants) according to the National guidelines excluding endotheliotropic treatment. After a 30-days period following conservative therapy we observed a 72% increase of NO level in the first group, 95% increase in the 2nd group and 539% increase in the 3rd. A reliable increase of nitric oxide metabolites correlated with improvement in clinical findings as well as functional tests. Treadmill test improved by 22%, 20%, and 32% respectively. Rheographic test reflecting endothelium-related vasodilatation improved in all study groups and its values exceeded the baseline by 15-25% (P