Impact of postprandial hypertriglyceridemia on vascular responses in patients with coronary artery disease: effects of ACE inhibitors and fibrates

Atherosclerosis. 2001 Sep;158(1):165-71. doi: 10.1016/s0021-9150(01)00408-7.


We analyzed vascular responses (endothelial function, oxidant stress) to postprandial hypertriglyceridemia (PHTG) in patients with coronary artery disease (CAD) to reveal potential therapeutical effects of angiotensin converting enzyme inhibition (ACE-I) and of lipid lowering (fibrate). The study population (n=39, mean age: 60 years) consisted of four groups, all of which had angiographically documented CAD. A high fat group (n=9) consumed a high fat meal, a low fat group (n=9) a low fat meal, and ACE-I (n=10) or fibrate (n=11) groups consumed a high fat meal plus lisinopril or fenofibrate. Serum triglycerides (TG) increased significantly 2 h after eating a test meal in all groups with the exception of the low fat group. In the high and low fat groups changes of serum TG were positively correlated (r=0.664, P<0.005) with changes of phorbol ester-activated leukocyte superoxide anion radical (O(2-.)) formation and were negatively correlated (r=-0.488, P<0.05) with flow-mediated brachial artery dilation (FMD). There was a negative correlation (r=-0.419, P=0.094) between FMD and changes of O(2-.) formation in the high and low fat groups. In the ACE-I and fibrate groups, O(2-.) formation decreased 2 h after eating a test meal (from 5.34+/-1.01 to 3.81+/-1.15 nmol/10(6)cells per min, P<0.01, and from 4.66+/-0.91 to 4.26+/-0.97 nmol/10(6)cells per min, P=0.374, respectively). However, endothelial function did not show any significant changes 2 h after eating a test meal in all groups. PHTG increases oxidant stress and further deteriorates endothelial function, even in patients with CAD. Both ACE-I and fibrates have an antioxidant effect but no acute beneficial effects in terms of endothelial function under conditions of PHTG in CAD patients.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
  • Blood Flow Velocity
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / drug therapy
  • Coronary Artery Disease / physiopathology*
  • Dietary Fats / administration & dosage
  • Endothelium, Vascular / physiopathology*
  • Female
  • Fenofibrate / therapeutic use*
  • Humans
  • Hypertriglyceridemia / complications
  • Hypertriglyceridemia / drug therapy
  • Hypertriglyceridemia / physiopathology*
  • Hypolipidemic Agents / therapeutic use*
  • Leukocytes / metabolism
  • Lisinopril / therapeutic use*
  • Male
  • Middle Aged
  • Oxidative Stress
  • Postprandial Period*
  • Superoxides / metabolism
  • Vasodilation


  • Angiotensin-Converting Enzyme Inhibitors
  • Dietary Fats
  • Hypolipidemic Agents
  • Superoxides
  • Lisinopril
  • Fenofibrate