The Role of Angiotensin Converting Enzyme Activity in the Severity of P Falciparum Infection and Hypertension Frequencyin Malaria Patients in Northwestern Nigeria

Recent studies have suggested the implications of some peptides of the renin-angiotensin aldosterone system (RAAS) in the pathophysiology of malaria infection. In this cross-sectional study, angiotensin converting enzyme (ACE) activity, P. falciparum load, pattern of severity of malaria infection and hypertension frequency were investigated to determine the ACE activity in infected adults and establish the relationship between: ACE activity and severe malaria; ACE activity and frequency of hypertension. In the study design, 800 participants attending some Health Care Facilities in northwestern Nigeria, in which 480 were malaria infected, were recruited for the study. The result showed that prevalence of malaria in northwestern Nigeria was higher in males (64.2%) than in females (35.8%) and the frequency was more pronounced in age range of 26-30 years. The ACE activity was higher in non-malaria than malaria subjects at P<0.001; within the malaria subjects, the ACE activity was higher in mild infections than in severe infections (P<0.001). Frequency of hypertension in malaria subjects was (36.2%) with greater frequency in subjects above 50 years (82.6%). ACE activity and frequency of hypertension were higher in mild than severe malaria infected participants. This finding validates the assertion that low levels of ACE may be implicated in the severity of malaria infection and the frequency of hypertension than in milder form of the malaria infection.