Some studies recently raised concerns that angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs), often used to treat hypertension, could aggravate the new coronavirus (COVID-19) infection.
However, European cardiologists strongly recommended keeping the usual anti-hypertensive treatment.
Chinese researchers released a study claiming that hypertensive patients taking an ACE inhibitor or ABR were more exposed to the risk of COVID-19 infection and that severe COVID-19 patients had a higher risk of myocardial damage.
Chinese cardiologists at First Affiliated Hospital of Zhengzhou University and First Affiliated Hospital of Xinjiang Medical University published their comment in Nature Reviews Cardiology on March 5.
They claimed that taking an ACE inhibitor or ABR increases angiotensin-converting enzyme 2 (ACE2), which COVID-19 virus uses to infiltrate human cells, thus raising the chance of the virus infection.
As concerns grew rapidly, some patients using the anti-hypertensive drugs and physicians discontinued or changed the medication.
However, the European Society of Cardiology (ESC) moved first to release a statement on Friday, calling patients and doctors not to stop the medication.
The ESC said hypotheses have been suggested that ACE inhibitors or ARBs could have potential adverse effects, based on initial reports from China and subsequent evidence that arterial hypertension may be associated with increased risk of mortality in hospitalized patients infected with COVID-19.
In social media sites, in particular, it has been suggested that these commonly used drugs may increase both the risk of infection and the severity of COVID-19, the ESC said. The concern comes from the observation that the COVID-19 virus binds to a specific enzyme called ACE2 to infect cells, and ACE2 levels are increased following treatment with ACE inhibitors and ARBs, it added.
However, the speculation about the safety of ACE inhibitors or ARB treatment concerning COVID-19 did not have a sound scientific basis or evidence to support it, the ESC said.
“The Council on Hypertension of the ESC wishes to highlight the lack of any evidence supporting the harmful effect of ACE inhibitor and ARB in the context of the pandemic COVID-19 outbreak,” the ESC emphasized.
The Korean Society of Hypertension also released a statement regarding the concerns over hypertension drugs on Tuesday.
It is true that COVID-19 infection raises the mortality rate in hypertension patients and that the virus binds to ACE2 to activate in humans, the society said.
However, clinical evidence for the effect of increasing ACE2 on hypertensive patients was insufficient, it noted. Therefore, doctors do not need to switch ACE inhibitors and ARBs to other drugs, it said.
“As the benefit of using hypertension drugs outweighs the risk of the drug discontinuation or alteration, we recommend patients with hypertension continue to take medicine,” it added.
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