POSTPRANDIAL INTESTINAL-DERIVED CHYLOMICRON AND CHYLOMICRON REMNANTS IN ESSENTIAL HYPERTENSIVE PATIENTS BEFORE AND AFTER PROLONGED CAPTOPRIL THERAPY

The metabolism of the postprandial intestinal-derived lipoproteins, ch ylomicron and chylomicron remnants, is not known in patients with esse ntial hypertension. After a fat meal, using the vitamin A test as a ma rker, retinyl palmitate was measured in the total plasma, chylomicron, and chylomicron remnant fractions in 14 untreated nondiabetic essenti al hypertensive patients with normal fasting lipids and lipoproteins. The vitamin A fat loading test was repeated in eight hypertensive pati ents after 3 months of captopril therapy. Fifteen matched normotensive subjects were used as controls. The untreated essential hypertensive patients had significantly higher chylomicron fraction concentration c urves (AUC 17,469 +/- 2553 mu g/L/h) P < .001 compared with the contro l group (AUC 13,208 +/- 1245 mu g/L/h), by two-way analysis of varianc e with repeated measurements. After 3 months of captopril therapy, the chylomicron fraction (AUC 9701 +/- 1566 mu g/L/h), and chylomicron re mnants fraction (AUC 3487 +/- 580 mu g/L/h) were much lower (P < .001) than before captopril therapy. Oral glucose tolerance tests were bord erline in five of the eight hypertensives before captopril treatment b ut returned to normal after 3 months of therapy. In summary, postprand ial intestinal-derived lipoprotein metabolism is altered in essential hypertensive patients. Captopril therapy caused significant improvemen t in the postprandial chylomicron metabolism.