A report from the BIOlogy Study to TAilored Treatment in Chronic Heart Failure (BIOSTAT-CHF) study, published in the European Heart Journal, shows that plasma angiotensin-converting enzyme 2 (ACE2) is higher in men than women.
ACE2 concentrations were measured in 1,485 men and 537 women with heart failure in 11 European countries (index cohort). Results were validated in 1,123 men and 575 women with heart failure from Scotland.
In both cohorts, patients with higher concentrations of ACE2 were more often men, more likely to have atrial fibrillation, a higher heart rate, and lower systolic blood pressure. In the index cohort, the mean plasma concentration was 5.38 in men compared with 5.09 in women (P<.001 in the validation cohort mean plasma concentration was men compared with women>
The use of ACE inhibitors, angiotensin receptor blockers (ARBs), or mineralocorticoid receptor antagonists (MRAs) was not an independent predictor of plasma ACE2. In the validation cohort, ACE inhibitor and ARB use were independent predictors of lower plasma ACE2, while the use of an MRA was an independent predictor of higher plasma ACE2 concentrations.
It has been suggested that ACE2 concentrations may increase vulnerability to SARS-CoV-2 in patients on renin-angiotensin-aldosterone system (RAAS) inhibitors.