The effect of angiotensin-converting enzyme inhibitors on plasma adipokine levels in normotensive patients with coronary artery disease.
BACKGROUND
The results of large clinical studies indicate that angiotensin-converting enzyme (ACE) inhibitors are effective agents in patients with coronary artery disease (CAD), even if their blood pressure is within normal limits.


METHODS
In the present study, we compared the effect of plasma- and tissue-type angiotensin-converting enzyme inhibitors on plasma levels of leptin and adiponectin in normotensive subjects with isolated CAD. We analyzed the samples obtained from 45 patients with isolated CAD, treated for 90 days with enalapril (20 mg/d, n = 15) or perindopril (4 mg/d, n = 16), or not receiving angiotensin-converting enzyme inhibitors (n = 14). Plasma leptin and adiponectin levels were determined at baseline, and after 30 and 90 days of treatment.


RESULTS
Compared to healthy subjects (n = 15), CAD patients had lower plasma levels of adiponectin and higher plasma content of leptin. Neither enalapril nor perindopril treatment was associated with any significant changes in blood pressure. Administration of perindopril resulted in an increase in plasma adiponectin and a reduction in plasma leptin. No significant changes in these hormones were observed after enalapril treatment.


CONCLUSIONS
Our results indicate that perindopril is superior to enalapril when it comes to affecting the hormonal function of human adipose tissue. This suggests that tissue-type angiotensin-converting enzyme inhibitors are a better treatment option for normotensive individuals with CAD than plasma-type ones.
Krysiak
Robert
R
Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice. r.krysiak@interia.pl
Sierant
Marian
M
Marek
Bogdan
B
Bienek
Radosław
R
Okopień
Bogusław
B
D052242:Adiponectin / Q000097:blood*; D000273:Adipose Tissue / Q000187:drug effects; D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D003327:Coronary Disease / Q000097:blood* / Q000188:drug therapy* / Q000503:physiopathology; D004656:Enalapril / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D020913:Perindopril / Q000627:therapeutic use*; D012189:Retrospective Studies
D052242:Adiponectin; D000806:Angiotensin-Converting Enzyme Inhibitors; D020738:Leptin; D004656:Enalapril; D020913:Perindopril