The effect of angiotensin-converting enzyme inhibitors on plasma adipokine levels in normotensive patients with coronary artery disease.

INTRODUCTION 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. MATERIAL AND 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.