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. 2023 Apr 1;41(4):545-553.
doi: 10.1097/HJH.0000000000003345. Epub 2023 Jan 24.

Association between blood pressure and angiotensin-converting enzymes activity in prepubertal children ∗

Ana R Gaspar  1 , Beatriz Andrade  2 , Sara Mosca  1   3   4 , Mariana Ferreira-Duarte  5   6 , Ana Teixeira  4   7 , Dina Cosme  8   9 , António Albino-Teixeira  8   9 , Fernanda A Ronchi  10 , Ana P Leite  10 , Dulce E Casarini  10 , José C Areias  11   12 , Teresa Sousa  8   9 , Alberto C Afonso  1   4   7 , Manuela Morato  5   6 , Liane Correia-Costa  1   4   7
Affiliations

Association between blood pressure and angiotensin-converting enzymes activity in prepubertal children ∗

Ana R Gaspar et al. J Hypertens. .

Abstract

Objectives: Angiotensin-converting enzymes' (ACEs) relationship with blood pressure (BP) during childhood has not been clearly established. We aimed to compare ACE and ACE2 activities between BMI groups in a sample of prepubertal children, and to characterize the association between these enzymes' activities and BP.

Methods: Cross-sectional study of 313 children aged 8-9 years old, included in the birth cohort Generation XXI (Portugal). Anthropometric measurements and 24-h ambulatory BP monitoring were performed. ACE and ACE2 activities were quantified by fluorometric methods.

Results: Overweight/obese children demonstrated significantly higher ACE and ACE2 activities, when compared to their normal weight counterparts [median (P25-P75), ACE: 39.48 (30.52-48.97) vs. 42.90 (35.62-47.18) vs. 43.38 (33.49-49.89) mU/ml, P for trend = 0.009; ACE2: 10.41 (7.58-15.47) vs. 21.56 (13.34-29.09) vs. 29.00 (22.91-34.32) pM/min per ml, P for trend < 0.001, in normal weight, overweight and obese children, respectively]. In girls, night-time systolic BP (SBP) and diastolic BP (DBP) increased across tertiles of ACE activity ( P < 0.001 and P = 0.002, respectively). ACE2 activity was associated with higher night-time SBP and DBP in overweight/obese girls ( P = 0.037 and P = 0.048, respectively) and night-time DBP in the BMI z-score girl adjusted model ( P = 0.018). Median ACE2 levels were significantly higher among nondipper girls (16.7 vs. 11.6 pM/min per ml, P = 0.009).

Conclusions: Our work shows that obesity is associated with activation of the renin-angiotensin-aldosterone system, with significant increase of ACE and ACE2 activities already in childhood. Also, we report sex differences in the association of ACE and ACE2 activities with BP.

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