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In hypercholesterolemic patients (n = 22, age 60.8 9.2), oral BH 4 (400 mg bid) for 4 weeks normalizes ACh-induced vasodilation, vascular oxidative stress, and NO and superoxide production ( Challenges Despite evidence that BH 4 and its analogs can improve endothelial function, the lack of large-scale trials and mixed outcomes of the published small-scale clinical studies have prevented their translation into current practice guidelines for CVD prevention and management (Heidenreich et al., 2022)

This can be achieved with a controlled intake of lipotropic nutrients

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