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ACEi have blood pressure\u2010independent effects that may make them preferred for certain patients. We aimed to evaluate the impact of ACEi on anti\u2010fibrotic biomarkers in African American hypertensive patients with left ventricular hypertrophy (LVH). We conducted a post hoc analysis of a randomized controlled trial in which hypertensive African American patients with LVH and vitamin D deficiency were randomized to receive intensive antihypertensive therapy plus vitamin D supplementation or placebo. We selected patients who had detectable lisinopril (lisinopril group) in plasma using liquid\u2010chromatography\/mass spectrometry analysis and compared them to subjects who did not (comparison group) at the one\u2010year follow\u2010up. The pro\u2010fibrotic marker type 1 procollagen C\u2010terminal propeptide (PICP) and the anti\u2010fibrotic markers matrix metalloproteinase\u20101 (MMP\u20101), tissue inhibitor of metalloproteinases 1 (TIMP\u20101), telopeptide of collagen type I (CITP), and N\u2010acetyl\u2010seryl\u2010aspartyl\u2010lysyl\u2010proline (Ac\u2010SDKP) peptide were measured. Sixty\u2010six patients were included, and the mean age was 46.2\u00a0\u00b1\u00a08\u00a0years. No difference was observed in the number and intensity of antihypertensive medications prescribed in each group. Patients with detectable lisinopril had lower blood pressure than those in the comparison group. The anti\u2010fibrotic markers Ac\u2010SDKP, MMP\u20101, and MMP\u20101\/TIMP\u20101 ratio were higher in patients with detectable ACEi (all <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.05). In a model adjusted for systolic blood pressure, MMP\u20101\/TIMP\u20101 (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.02) and Ac\u2010SDKP (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001) levels were associated with lisinopril. We conclude that ACEi increase anti\u2010fibrotic biomarkers in hypertensive African Americans with LVH, suggesting that they may offer added benefit over other agents in such patients.<\/jats:p>","DOI":"10.1111\/jch.14206","type":"journal-article","created":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T06:38:36Z","timestamp":1615444716000},"page":"1008-1016","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Angiotensin\u2010converting enzyme inhibitors increase anti\u2010fibrotic biomarkers in African Americans with left ventricular hypertrophy"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8445-9665","authenticated-orcid":false,"given":"Cesar","family":"A. 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