The Role of Quinapril in the Presence of a Weight Loss Regimen: Endothelial Function and Markers of Obesity in Patients With the Metabolic Syndrome

Abstract

Forty-four patients with the metabolic syndrome were placed on a reduced-calorie and reduced-fat regimen to lose weight throughout a 56-week period. The patients were treated in a crossover fashion with placebo and the angiotensin-converting enzyme inhibitor quinapril for 24 weeks each. The study measured endothelial-dependent flow-mediated dilation plus serum obesity markers of adiponectin and leptin. Metabolic parameters improved after 56 weeks. Serum adiponectin level increased by 18% (P<.05 vs baseline) and serum leptin level decreased by 16% with placebo (P<.05 vs baseline). These findings were potentiated further in the quinapril group. In comparison with baseline, flow-mediated dilation was increased by 13% in the placebo group (P=.055 vs baseline) and by 43% in the quinapril group (P<.001 vs baseline and placebo). These findings suggest that weight loss therapy improves endothelial function and markers of obesity. These results are potentiated with quinapril and are independent of changes in metabolic parameters.

Circulating ACE is a predictor of weight loss maintenance not only in overweight and obese women, but also in men

“…A later study on weight loss by reduced-calorie and reduced-fat regimen for about 6 months confirmed this leptin-lowering effect. 23 In a 3-month treatment for obesity-related hypertension, ACE inhibitors together with calcium channel blockers were able to support the weight-reducing actions and concomitant metabolic changes induced by sibutramine. 24 However, in these human studies, no information on the effect of ACE inhibitors per se on the weight loss and/or maintenance has been reported.…”

The effect of amlodipine besylate, losartan potassium, olmesartan medoxomil, and other antihypertensives on central aortic blood pressure and biomarkers of vascular function

“…These include ethnic groups such as African Americans, patients with obesity, and patients with renal disease, metabolic syndrome, diabetes mellitus, and/ or existing vascular disease. Improvement in inflammatory and other biomarkers has been reported with ARBs and ACE inhibitors in patients with obesity and metabolic syndrome [Nagamia et al 2007;Sola et al 2005] and in patients with hypertension with and without type 2 diabetes mellitus (T2DM) [Derosa et al 2010;Persson et al 2006]. Similarly, calcium channel blockers (CCBs) have been shown to improve markers of inflammation in patients with hypertension [Komoda et al 2010;ShurtzSwirski et al 2006], while b-blockers such as nebivolol were shown to modify markers of inflammation and obesity in African Americans with obesity and hypertension [Merchant et al 2010].…”

The Effects of Antihypertensive Agents in Metabolic Syndrome – Benefits Beyond Blood Pressure Control

“…These include ethnic groups such as African Americans, obese patients, and patients with renal disease, metabolic syndrome, diabetes mellitus, and/or existing vascular disease. Improvements in inflammatory and other biomarkers has been reported with ARBs and ACEIs in obese patients with metabolic syndrome [7,8] and in hypertensive patients with and without type 2 diabetes mellitus (T2DM) [9,10]. Similarly, CCBs have been shown to improve markers of inflammation in patients with hypertension [11,12], while -blockers such as nebivolol were shown to modify markers of inflammation and obesity in obese African Americans with hypertension [13].…”