Serum concentration of renin-angiotensin system components in association with ACE I/D polymorphism among hypertensive subjects in response to ACE inhibitor therapy

Hristova, Mariyana G.; Stanilova, Spaska; Miteva, Lyuba

doi:10.1080/10641963.2018.1529782

Cited by 20 publications

(14 citation statements)

References 28 publications

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“…11 Moreover, circulating amounts of ACE2 are increased in patients with hypertension or diabetes, and levels are further increased by different drugs, including ACEIs and ARBs. 14,15 It should also be emphasised that specific alleles control ACE2 expression, activity, and response to ACEIs. 15 In addition to animal models, humans given ACEIs, ARBs, or both, had increased ACE2 levels on intestine luminal cells.…”

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confidence: 99%

Antihypertensive drugs and risk of COVID-19? – Authors' reply

Fang

Karakiulakis

Roth

2020

The Lancet Respiratory Medicine

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Antihypertensive drugs and risk of COVID-19? Authors' replyWe thank Joshua Brown, Kevin Lo and colleagues, and Christopher Tignanelli and colleagues for their responses to our Correspondence 1 , and we welcome the opportunity to reply.The fast-developing pandemic of corona virus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported from Wuhan, China, 2 and has spread globally. As of March 22, 2020, 307 297 people have been infected by SARS-CoV-2, with 13 049 deaths and 92 382 people recovered. Several reports have summarised the clinical and epidemiological features of COVID-19 and have shown specific comorbidities associated with increased risk of infection and developing into a severe or fatal case. Of 1099 infected patients, 173 had severe disease, in whom the most common comorbidities were hypertension (24%), diabetes (16%), coronary heart disease (6%), and cerebrovascular disease (2%). 3 In a second cohort of 41 patients hospitalised with COVID-19, 4 diabetes (20%), hypertension (15%), and cardiovascular disease (15%) were frequent comorbidities. Among 191 patients hospitalised with COVID-19, 5 the most common comorbidities with significant effects on mortality were hypertension (30%; p=0•0008), diabetes (36%; p=0•0051), and coronary heart disease (15%; p=0•0001). In an analysis of 201 patients with COVID-19, 6 84 (42%) patients developed acute respiratory distress syndrome, with hypertension (27%) and diabetes (19%) as the most common comorbidities.Hypertension, diabetes, and cardiovascular disease, which seem to be the most common comorbidities in patients with COVID-19, are typically treated with drugs that inhibit the renin-angiotensin system (RAS), including angiotensin-converting

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confidence: 99%

Antihypertensive drugs and risk of COVID-19? – Authors' reply

Fang

Karakiulakis

Roth

2020

The Lancet Respiratory Medicine

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“…Furthermore, another study [26] demonstrated an increased gene expression for ACE2 in the small intestine of patients under ACE inhibitor/ARB treatment compared with untreated controls. In addition, the elevation of serum ACE2 was only found in patients with unsatisfactory blood pressure control utilizing ACE inhibitor therapy, as reported in a study among hypertensive subjects [27]. Therefore, the effect of RAS inhibitors on ACE2 among human subjects is mainly due to the expression of ACE2 in the plasma, kidney and gastrointestinal system, and is not the known effect, if any, of RAS inhibitors on the expression of ACE2 in human airway epithelial cells.…”

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confidence: 88%

Cardiovascular Disease and Use of Renin-Angiotensin System Inhibitors in COVID-19

Kow

Zaidi

Hasan

2020

Am J Cardiovasc Drugs

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There is ongoing debate on the safety of renin-angiotensin system (RAS) inhibitors in COVID-19. Recently published studies highlight a potential relationship between cardiovascular disease (CVD) and COVID-19. This article aims to summarize the evidence on the use of RAS inhibitors in CVD patients with COVID-19, focusing on safety issues of the RAS inhibitors and their relationship with COVID-19. Key PointsCardiovascular disease (CVD) has been reported as one of the most common comorbidities among patients with severe COVID-19

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“…The SARS-CoV-2, the causative agent for COVID-19, binds to the ACE2 receptor on host cells to gain entry [5]. In several animal models and human studies, the expression of ACE2 is increased with the administration of RAS inhibitors, which suggests a possible increased susceptibility to SARS-CoV-2 with the use of RAS inhibitors [6][7][8].…”

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confidence: 99%

Mortality and disease severity among COVID-19 patients with hypertension receiving renin-angiotensin system inhibitors

Hasan

Kow

Merchant

2020

Preprint

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The use of renin-angiotensin system (RAS) inhibitors, including angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), is alleged to cause a more severe course of novel coronavirus disease 2019 .We systematically reviewed the available studies to assess the association of RAS inhibitors with mortality as well as disease severity in COVID-19 patients. A systematic literature search was performed to retrieve relevant original studies investigating mortality and severity (critical disease) in COVID-19 patients with and without exposure to ACEIs/ARBs. A total of 13 original studies were included; 11 studies reporting on mortality and 10 studies reporting on disease severity in ACEI/ARB exposed and unexposed groups. Among hypertensive COVID-19 patients, the use of ACEI/ARB was associated with a significant reduction in the risk of mortality exhibiting a pooled relative risk of 0.73 (95% confidence interval: 0.63-0.86). Moreover, there was no significant difference in the risk of developing severe/critical COVID-19 disease between ACEI/ARB and non-ACEI/ARB groups showing relative risk of 0.72 (95% confidence interval: 0.46-1.12). The data indicate that the use of ACEI/ARB was associated with reduced risk of mortality in COVID-19 patients taking these medications to manage their hypertension.

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Serum concentration of renin-angiotensin system components in association with ACE I/D polymorphism among hypertensive subjects in response to ACE inhibitor therapy

Cited by 20 publications

References 28 publications

Antihypertensive drugs and risk of COVID-19? – Authors' reply

Antihypertensive drugs and risk of COVID-19? – Authors' reply

Cardiovascular Disease and Use of Renin-Angiotensin System Inhibitors in COVID-19

Mortality and disease severity among COVID-19 patients with hypertension receiving renin-angiotensin system inhibitors

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