The beneficial effects of angiotensin-converting enzyme inhibitors on serum asymmetric dimethylarginine levels in the patients with cardiovascular disease.

ACEI and AT1 receptor antagonists are the drugs most consistently shown to reduce ADMA level in humans. Unfortunately, most of the human studies addressing the effect of pharmacotherapy on ADMA metabolism were accomplished on small patient subgroups and were relatively shortlasting. Besides, L-arginine was rarely measured in most studies, whereas L-arginine/ADMA ratio may be more important for NO synthase function than ADMA itself, and arginine concentration may be either increased or decreased by pharmacotherapy. We strongly believe that agents affecting ADMA more specifically (protein arginine methyltransferases inhibitors or dimethylarginine dimethylaminohydrolase inducers) deserve further investigation.