Stunting growth: association of the blood pressure levels and ACE activity in early childhood

Abstract

Angiotensin converting enzyme (ACE) converts angiotensin I to angiotensin II and inactive bradykinin. Several studies carried out in our laboratory have consistently identified three isoforms of ACE, at 65, 90 and 190 kDa, with the 90-kDa isoform being a possible genetic marker of hypertension. Based on these observations and the fact that nutritional stunting can be associated with hypertension, we have investigated the expression and activity of ACE in stunted children and its association with blood pressure (BP) levels and nutritional state. Sixty children aged 2-7 years were selected for this study. A urine sample was collected from each child. Angiotensin converting enzyme activity was evaluated using two different substrates, and ACE expression was detected by Western blotting. Our results show that nutritional stunting is associated with high ACE activity in childhood and that adjustment by gender does not modify the strength of this association. A greater percentage of stunted children had increased BP levels, and this clinical parameter was inversely correlated with anthropometric indicators. A greater urinary protein expression of the three ACE isoforms was observed in the group of children with growth stunting. Our findings suggest that the reported high risk of hypertension in stunted adolescents and adults are, at least partly, associated with abnormalities in the renin-angiotensin system.

Long-Lasting Effects of Undernutrition

“…There was a significant association between the circulating levels of both angiotensin II and ACE activity and systolic BP (SBP, Figure 4). Febba et al [68] recently showed that ACE activity is increased, together with an increase in systolic and diastolic pressure in children with stunting independent of birth weight.…”

Latin American consensus on hypertension in patients with diabetes type 2 and metabolic syndrome

“…Além disso, na América Latina, encontra-se uma alta prevalência de hipertensão arterial em crianças, adolescentes e adultos com crescimento interrompido por má nutrição (137)(138)(139)(140)(141)(142)(143)(144). Um estudo realizado no Brasil (137), que investigou o comportamento da pressão arterial em uma amostra aleatória de adolescentes com atraso no crescimento (10-16A, n = 56), que vivem em favelas, mostrou um elevado percentual de pessoas com uma pressão acima do percentil 90 e 95, após o ajuste para altura e estavam em maior risco de desenvolver hipertensão.…”

Consenso latino-americano de hipertensão em pacientes com diabetes tipo 2 e síndrome metabólica

“…É sabido que na América Latina desnutrição materna e desnutrição infantil são um grande problema a ser resolvido em uma proporção significativa das populações pobres (136). Além disso, na América Latina, encontra-se uma alta prevalência de hipertensão arterial em crianças, adolescentes e adultos com crescimento interrompido por má nutrição (137)(138)(139)(140)(141)(142)(143)(144). Um estudo realizado no Brasil (137), que investigou o comportamento da pressão arterial em uma amostra aleatória de adolescentes com atraso no crescimento (10-16A, n = 56), que vivem em favelas, mostrou um elevado percentual de pessoas com uma pressão acima do percentil 90 e 95, após o ajuste para altura e estavam em maior risco de desenvolver hipertensão.…”