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Objective. To evaluate the long-term effects of the angiotensin converting enzyme inhibitor enalapril and of the angiotensin II type 1 receptor antagonist losartan on the angiotensin converting enzyme activity in T-lymphocytes and on the proliferation of peripheral blood mononuclear cells (PBMC) in patients with essential hypertension. Design. Randomised, placebo-controlled, double-blind, cross-over design. Methods. Nine patients with sitting blood pressure $ 95 mm Hg and # 105 mm Hg at the end of a 4-week placebo run-in period entered the double-blind phase of the study, which consisted of three 6-week periods during which patients were treated with placebo, enalapril 20 mg o.d. or losartan 50 mg o.d. The angiotensin converting enzyme activity in T-lymphocytes was measured as the activity of the degradation of the substrate Hippuril-His-Leu and as the appearance of the dipeptide HisLeu, which was quantified spectrofluorometrically. The de novo synthesis of DNA, RNA and protein in PBMC was measured by, respectively, [H]thymidine, [H]uridine or [H]leucine incorporation. Results. Enalapril but not losartan suppressed (P # 0.01) the angiotensin converting enzyme activity in plasma, while it stimulated (P # 0.05) the angiotensin converting enzyme activity in circulating T-lymphocytes. Neither enalapril nor losartan affected the proliferation of PBMC measured as de novo synthesis of DNA, RNA and protein. Conclusions. Our data show that during angiotensin converting enzyme inhibition with enalapril the angiotensin converting enzyme activity was decreased in plasma and increased in T-lymphocytes, while the proliferation of PBMC was not affected. Angiotensin II receptor type 1 antagonism losartan had no effect on these variables.

Angiotensin converting enzyme activity and lympho-proliferative response during enalapril and losartan administration in men