title: The effect of perindopril and enalapril on plasma resistin levels in normotensive patients with coronary heart disease.
abstract: BACKGROUND
  It has been suggested that adipose tissue hormones are involved in the mechanism of action of angiotensin-converting enzyme (ACE) inhibitors. Very little is known as to whether the action on resistin contributes to the clinical effectiveness associated with the use of these agents.
  
  
  METHODS
  The aim of this study was to compare the effects of plasma- and tissue-type ACE inhibitors (enalapril and perindopril) on plasma resistin content in coronary artery disease (CAD) individuals without arterial hypertension. The samples used in our analysis were obtained at baseline, and again after 30 and 90 days of treatment, from 22 patients receiving enalapril (20 mg/d), 24 receiving perindopril (4 mg/d), 20 receiving no angiotensin-converting enzyme inhibitors, and 20 healthy subjects. Each group consisted of patients sensitive and resistant to insulin.
  
  
  RESULTS
  Plasma resistin content was higher in normotensive CAD patients, particularly in the subgroup with reduced insulin sensitivity, than in the control group. Both ACE inhibitors produced a weak effect on blood pressure. Perindopril treatment reduced resistin levels, while enalapril only tended to decrease its content. The effect of perindopril was stronger in insulin-resistant than in insulin-sensitive subjects.
  
  
  CONCLUSIONS
  Our results demonstrate the superiority of perindopril over enalapril in reducing plasma resistin levels, particularly in insulin-resistant subjects. They justify the choice of a tissue-type ACE inhibitor in normotensive CAD individuals, requiring administration of this group of agents.
authors.affiliation: Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland. r.krysiak@interia.pl
authors.forename: Robert
authors.initials: R
authors.lastname: Krysiak
authors.forename: Marian
authors.initials: M
authors.lastname: Sierant
authors.forename: Bogdan
authors.initials: B
authors.lastname: Marek
authors.forename: Bogusław
authors.initials: B
authors.lastname: Okopień
mesh_terms: D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000145:classification / Q000494:pharmacology*; D003327:Coronary Disease / Q000097:blood* / Q000188:drug therapy*; D004656:Enalapril / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D008875:Middle Aged; D020913:Perindopril / Q000494:pharmacology*; D052243:Resistin / Q000097:blood*
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D052243:Resistin; D004656:Enalapril; D020913:Perindopril