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, chylomicron and chylomicron remnants, is not known in patients with essential hypertension. After a fat meal, using the vitamin A test as a marker, retinyl palmitate was measured in the total plasma, chylomicron, and chylomicron remnant fractions in 14 untreated nondiabetic essential hypertensive patients with normal fasting lipids and lipoproteins. The vitamin A fat loading test was repeated in eight hypertensive patients 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 curves (AUC 17,469 ± 2553 μg/L/h) P< .001 compared with the control group (AUC 13,208 ± 1245 μg/L/h), by two-way analysis of variance with repeated measurements. After 3 months of captopril therapy, the chylomicron fraction (AUC 9701 ± 1566 μg/L/h), and chylomicron remnants fraction (AUC 3487 ± 580 μg/L/h) were much lower (P< .001) than before captopril therapy. Oral glucose tolerance tests were borderline in five of the eight hypertensives before captopril treatment but returned to normal after 3 months of therapy. In summary, postprandial intestinal-derived lipoprotein metabolism is altered in essential hypertensive patients. Captopril therapy caused significant improvement in the postprandial chylomicron metabolism.