Optimisation of arterial hypertension pharmacotherapy in patients with metabolic syndrome: potential of zofenopril

Metabolic syndrome (MS) is an important problem of the modern medicine, due to its substantial impact on cardiovascular risk. Visceral fat tissue is an endocrine organ, producing a wide spectrum of biologically active substances - adipokines, which influence atherosclerosis progression, thrombosis, insulin resistance, and other processes. The aim of this study was to assess the activity of adipokines, endothelial dysfunction markers, and systemic inflammation, in patients with arterial hypertension (AN) and MS, who received an ACE inhibitor zofenopril. This open study of pleiotropic and antihypertensive effects of zofenopril included 32 patients with Stage I-II All and MS (18 men, 14 women; mean age 54 years (from 48 to 60,5 years)). Zofenopril demonstrated not only a good antihypertensive effect, but also a significant (p=0,001) decrease in leptin levels, from 18,7 ng/ml (12,8;34,0) to 17,5 ng/ml (12,5;30,6); some increase (p=0,12) in adiponectin levels, from 10,4 mkg/ml (7,5;14,1) to 13,6 mkg/ml (6,5;17,7); a significant (p=0,001) reduction in endothelin-1 activity, from 0,38 fmol/l (0,25;1,03) to 0,34 fmol/l (0,14;0,88); and a slight decrease (p=0,03) in intercellular adhesion molecule ([CAM) levels, from 323,9 ng/ml (242,25;512,31) to 315,47 ng/ml (187,31;424,38).