Quinapril, an ACE inhibitor, reduces markers of oxidative stress in the metabolic syndrome.
OBJECTIVE
Patients with the metabolic syndrome often have abnormal levels of proinflammatory and pro-oxidative mechanisms within their vasculature. We sought to determine whether the ACE inhibitor quinapril regulates markers of oxidative stress in the metabolic syndrome.


METHODS
Forty patients with the metabolic syndrome were randomized in a double-blind manner to either the ACE inhibitor quinapril (20 mg/day) or matching placebo for 4 weeks. Serum markers of vascular oxidative stress were measured.


RESULTS
After 4 weeks of therapy, serum 8-isoprostane was reduced by 12% in the quinapril group when compared with placebo (quinapril, 46.7 +/- 1.0; placebo, 52.7 +/- 0.9 pg/ml; P = 0.001). Erythrocyte superoxide dismutase activity increased 35% in the quinapril group when compared with placebo (quinapril, 826.3 +/- 17.1; placebo, 612.3 +/- 6.9 units/g Hb; P < 0.001). In addition, lag time to oxidation of LDL, a marker of oxidative stress, was increased by 48% in the quinapril group when compared with placebo (quinapril 89.2 +/- 9.2 vs. placebo 60.1 +/- 12.3 min; P < 0.001). Therapy with quinapril was well tolerated.


CONCLUSIONS
The addition of the ACE inhibitor quinapril reduces markers of vascular oxidative stress and may attenuate the progression of the pathophysiology seen in the metabolic syndrome.
Khan
Bobby V
BV
Division of Cardiology, Emory University School of Medicine, Atlanta, GA 30303, USA. bkhan@emory.edu
Sola
Srikanth
S
Lauten
Wright B
WB
Natarajan
Rama
R
Hooper
W Craig
WC
Menon
Rekha G
RG
Lerakis
Stamatios
S
Helmy
Tarek
T
D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D004311:Double-Blind Method; D004912:Erythrocytes / Q000201:enzymology; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000188:drug therapy*; D018384:Oxidative Stress / Q000187:drug effects*; D000077583:Quinapril; D013482:Superoxide Dismutase / Q000097:blood; D044005:Tetrahydroisoquinolines / Q000627:therapeutic use*
D000806:Angiotensin-Converting Enzyme Inhibitors; D044005:Tetrahydroisoquinolines; D013482:Superoxide Dismutase; D000077583:Quinapril