Does Alpha‑lipoic Acid Supplementation Modulate Cardiovascular Risk Factors in Patients with Stroke? A Randomized, Double‑blind Clinical Trial

Vida Mohammadi, Fariborz Khorvash, Awat Feizi, Gholamreza Askari


Background: Stroke as a devastating condition is one of the major causes of death worldwide. It is accountable for long time disability with high personal and social cost in adults. There are several risk factors for stroke such as diabetes and hypertension. Alpha‑lipoic acid (ALA) as an antioxidant can be a risk modifer in these patients. We designed this trial to scrutinize the possible effects of ALA consumption on some cardiovascular risk factors in patients experienced stroke.

Methods: In this randomized, double‑blind, placebo‑controlled clinical trial, 67 patients experienced stroke were randomly allocated into two groups (taking a 600 mg ALA supplement or placebo daily for 12 weeks).
Fasting blood sugar (FBS), fasting insulin and systolic (SBP), and diastolic blood pressure (DBP) were measured before and after intervention in this study. Statistical analyses were performed using SPSS version 16 (SPSS Inc., Chicago, IL, USA) software.

Results: Primary features were similar in the intervention and placebo groups (P > 0.05). After the intervention period, SBP (P < 0.001), DBP (P < 0.001) and FBS (P < 0.001) reduced in ALA group compared with placebo group, signifcantly. No signifcant change was seen in insulin level (P = 0.82).

Conclusions: Results of this trial indicated that 12 weeks supplementation with 600 mg ALA has benefcial effects on SBP, DBP, and FBS but has no effect on insulin level.

Keywords: Blood glucose, blood pressure, insulin, thioctic acid

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Packer L, Witt EH, Tritschler HJ. Alpha‑lipoic acid as a

biological antioxidant. Free Radic Biol Med 1995;19:227‑50.

Packer L. Alpha‑lipoic acid: A metabolic antioxidant which

regulates NF‑kappa B signal transduction and protects against

oxidative injury. Drug Metab Rev 1998;30:245‑75.

Packer L, Tritschler HJ, Wessel K. Neuroprotection by the

metabolic antioxidant alpha‑lipoic acid. Free Radic Biol Med


Heitzer T, Finckh B, Albers S, Krohn K, Kohlschütter A,

Meinertz T. Beneficial effects of alpha‑lipoic acid and ascorbic

acid on endothelium‑dependent, nitric oxide‑mediated vasodilation

in diabetic patients: Relation to parameters of oxidative stress.

Free Radic Biol Med 2001;31:53‑61.

de Queiroz TM, Xia H, Filipeanu CM, Braga VA,

Lazartigues E. α‑Lipoic acid reduces neurogenic hypertension by

blunting oxidative stress‑mediated increase in ADAM17. Am J

Physiol Heart Circ Physiol 2015;309:H926‑34.

Micili SC, Ergur BU, Ozogul C, Sarioglu S, Bagriyanik HA,

Tugyan K, et al. Effects of lipoic acid in an experimentally

induced hypertensive and diabetic rat model. Clin Exp Hypertens


Vasdev S, Gill VD, Parai S, Gadag V. Effect of moderately high

dietary salt and lipoic acid on blood pressure in Wistar‑Kyoto

rats. Exp Clin Cardiol 2007;12:77‑81.

Mohammadi V, Khalili M, Eghtesadi S, Dehghani S, Jazayeri S,

Aghababaee SK, et al. The effect of alpha‑lipoic acid (ALA)

supplementation on cardiovascular risk factors in men with

chronic spinal cord injury: A clinical trial. Spinal Cord


Noori N, Tabibi H, Hosseinpanah F, Hedayati M, Nafar M.

Effects of combined lipoic acid and pyridoxine on albuminuria,

advanced glycation end‑products, and blood pressure in diabetic

nephropathy. Int J Vitam Nutr Res 2013;83:77‑85.

Mazloom Z, Ansar H. The effect of alpha‑lipoic acid on

blood pressure in type 2 diabetics. Iran J Endocrinol Metab


Singh U, Jialal I. Alpha‑lipoic acid supplementation and diabetes.

Nutr Rev 2008;66:646‑57.

Evans JL, Goldfine ID. Alpha‑lipoic acid: A multifunctional

antioxidant that improves insulin sensitivity in patients with

type 2 diabetes. Diabetes Technol Ther 2000;2:401‑13.

Jacob S, Henriksen EJ, Schiemann AL, Simon I, Clancy DE,

Tritschler HJ, et al. Enhancement of glucose disposal in patients

with type 2 diabetes by alpha‑lipoic acid. Arzneimittelforschung


Goraca A, Huk‑Kolega H, Piechota A, Kleniewska P,

Ciejka E, Skibska B. Lipoic acid‑Biological activity and

therapeutic potential. Pharmacol Rep 2011;63:849‑58.

Han T, Bai J, Liu W, Hu Y. A systematic review and

meta‑analysis of α‑lipoic acid in the treatment of diabetic

peripheral neuropathy. Eur J Endocrinol 2012;167:465‑71.

Berressem D, Koch K, Franke N, Klein J, Eckert GP. Intravenous

treatment with a long‑chain omega‑3 lipid emulsion provides

neuroprotection in a murine model of ischemic stroke‑A pilot

study. PLoS One 2016;11:e0167329.

Jauch EC, Saver JL, Adams HP Jr., Bruno A, Connors JJ,

Demaerschalk BM, et al. Guidelines for the early management

of patients with acute ischemic stroke: A guideline for healthcare

professionals from the American Heart Association/American

Stroke Association. Stroke 2013;44:870‑947.

Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD,

Borden WB, et al. Heart disease and stroke statistics‑2013

update: A report from the American Heart Association.

Circulation 2013;127:e6‑e245.

Wolf PA, D’Agostino RB, Belanger AJ, Kannel WB. Probability

of stroke: A risk profile from the Framingham study. Stroke


MacMahon S, Rodgers A. Blood pressure, antihypertensive

treatment and stroke risk. J Hypertens Suppl 1994;12:S5‑14.

Hagen TM, Moreau R, Suh JH, Visioli F. Mitochondrial decay

in the aging rat heart: Evidence for improvement by dietary

supplementation with acetyl‑L‑carnitine and/or lipoic acid. Ann

N Y Acad Sci 2002;959:491‑507.

Mohammadi V, Dehghani S, Askari G. Does alpha‑lipoic acid

supplement regulate blood pressure? A systematic review of

randomized, double‑blind placebo‑controlled clinical trials. Int J

Prev Med 2016;7:122.

El Midaoui A, de Champlain J. Prevention of hypertension,

insulin resistance, and oxidative stress by alpha‑lipoic acid.

Hypertension 2002;39:303‑7.

Sola S, Mir MQ, Cheema FA, Khan‑Merchant N,

Menon RG, Parthasarathy S, et al. Irbesartan and lipoic acid

improve endothelial function and reduce markers of inflammation

in the metabolic syndrome: Results of the Irbesartan and Lipoic

Acid in Endothelial Dysfunction (ISLAND) study. Circulation


Rahman ST, Merchant N, Haque T, Wahi J, Bhaheetharan S,

Ferdinand KC, et al. The impact of lipoic acid on endothelial

function and proteinuria in quinapril‑treated diabetic patients

with stage I hypertension: Results from the QUALITY study.

J Cardiovasc Pharmacol Ther 2012;17:139‑45.

Jacob S, Ruus P, Hermann R, Tritschler HJ, Maerker E,

Renn W, et al. Oral administration of RAC‑alpha‑lipoic acid

modulates insulin sensitivity in patients with type‑2 diabetes mellitus:

A placebo‑controlled pilot trial. Free Radic Biol Med 1999;27:309‑14.