title: Effect of sulfhydryl and non-sulfhydryl angiotensin-converting enzyme inhibitors on endothelial function in essential hypertensive patients.
abstract: BACKGROUND
  Oxidative inactivation of nitric oxide (NO) is regarded as an important cause of reduced endothelium-dependent vasodilation in essential hypertension. Because zofenopril, an angiotensin-converting enzyme (ACE) inhibitor with a sulfhydryl (SH) group, has demonstrated antioxidant properties and to reduce adhesion molecule expression in vitro, in this study we evaluated the effect of this drug in comparison with the carboxylic ACE inhibitor ramipril and the beta-adrenoreceptor blocker atenolol on (1) circulating adhesion molecules and some oxidative stress parameters and (2) endothelium-dependent vasodilation in essential mildly hypertensive patients.
  
  
  METHODS
  A total of 45 healthy subjects and 45 matched hypertensive patients participated in the study. Hypertensive patients were randomly treated with zofenopril (15 to 30 mg/d), ramipril (2.5 to 5 mg/d), and atenolol (50 to 100 mg/d). At baseline and after an 8-week therapy we evaluated blood pressure (BP) values, plasma and LDL hydroperoxides, plasma 8-isoprostanes, circulating levels of oxidized-(ox)LDL and of adhesion molecules (intercellular cell adhesion molecule-1 [ICAM-1], and vascular cell adhesion molecule-1 [VCAM-1], and E-selectin). Furthermore, all patients underwent ultrasound detection of brachial artery reactivity and endothelium-dependent dilation (flow-mediated dilation, FMD) was evaluated.
  
  
  RESULTS
  All the treatments determined similar significant (P < .001) reduction of both systolic and diastolic BP values. Plasma (P < .01) and LDL hydroperoxides (P < .01), plasma 8-isoprostanes (P < .05), circulating oxLDL (P < .05), and adhesion molecules (P < .05) were significantly reduced only in patients receiving zofenopril. Similarly FMD was significantly increased (P < .001) in the zofenopril-treated group.
  
  
  CONCLUSIONS
  Our results suggest that in mildly hypertensive patients without organ damage zofenopril, beyond its BP-lowering effects and through its sustained antioxidant activity, offers important advantages in reducing endothelial activation.
authors: Department of Biomedical and Surgical Sciences (Medicina D), University of Verona, Verona, Italy.
authors: Anna Fratta
authors: AF
authors: Pasini
authors: Ulisse
authors: U
authors: Garbin
authors: Maria Cristina
authors: MC
authors: Nava
authors: Chiara
authors: C
authors: Stranieri
authors: Michele
authors: M
authors: Pellegrini
authors: Veronica
authors: V
authors: Boccioletti
authors: Maria Laura
authors: ML
authors: Luchetta
authors: Paolo
authors: P
authors: Fabrizzi
authors: Vincenzo
authors: V
authors: Lo Cascio
authors: Luciano
authors: L
authors: Cominacini
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D001262:Atenolol / Q000494:pharmacology / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002216:Captopril / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D015815:Cell Adhesion Molecules / Q000097:blood / Q000187:drug effects; D008076:Cholesterol, HDL / Q000097:blood; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology*; D005260:Female; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects / Q000502:physiology; D017257:Ramipril / Q000494:pharmacology / Q000627:therapeutic use*; D013438:Sulfhydryl Compounds / Q000494:pharmacology / Q000627:therapeutic use*; D014280:Triglycerides / Q000097:blood; D014664:Vasodilation / Q000187:drug effects
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D001786:Blood Glucose; D015815:Cell Adhesion Molecules; D008076:Cholesterol, HDL; D013438:Sulfhydryl Compounds; D014280:Triglycerides; C044958:zofenopril; D001262:Atenolol; D002216:Captopril; D017257:Ramipril