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We have read with interest Forsyth et al’s article in your journal
. They have concluded that “angiotensin converting enyzme (ACE) is
increasingly identified as a risk factor for cardiovascular disease, and
serum activity in infancy may contribute to the link between low birth
weight and later cardiovascular events.”
We think, in this manner that it is inappropriate to come to a...
We think, in this manner that it is inappropriate to come to a conclusion
by means of Forsyth et al’s study methods since none of the cardiologic
parameters of any healthy term infants were assessed in the study. Though
emphasizing the ACE being important in regulation of peripheral blood
pressure, arterial pressure measurements on infants were done neither at
birth, nor 1st and 3rd months. Nevertheless, some influent questions
mentioned below remained unanswered:
1.How many infants of high ACE level
had any cardiologic problems?
2.How many infants were assessed
3.Are all of the infants of lower ACE levels
The authors stressed on their conclusion that especially “later”
cardiovascular events had a relation with ACE level. However “later”
cardiovascular events could not be foreseen by following up the infants
for 3 months.
Overall, mentioning the relation would be impossible. There is a need for
controlled studies having longitudinal extended case numbers and well-
monitorized cardiologic parameters.
(1). Forsyth JS, Reilly J, Fraser CG, Struthers AD. Angiotensin converting
enyzme activity in infancy is related to birth weight. Arch Dis Child
Fetal Neonatal Ed 2004;89:F442-F444.