ARB might be superior to ACEI for treatment of hypertensive COVID-19 patients.

Abstract

The administration of ACEI/ARB (angiotensin-converting enzyme inhibitors/Angiotension II receptor blockers) in COVID-19 (coronavirus disease 2019) patients with hypertension exhibits a lower risk of mortality compared with ACEI/ARB non-users. In this context, an important question arises: is ACEI or ARB more suitable for the treatment of hypertensive COVID-19 patients? Taken into consideration the following four rationales, ARB may offer a more significant benefit than ACEI for the short-term treatment of hypertensive COVID-19 patients: 1. ACEI has no inhibition on non-ACE-mediated Ang II production under infection conditions, whereas ARB can function properly regardless of how Ang II is produced; 2. ACEI-induced bradykinin accumulation may instigate severe ARDS while ARB has no effects on kinin metabolism; 3. ARB alleviates viscous sputa production and inflammatory reaction significantly in contrast to ACEI; 4. ARB may attenuate the lung fibrosis induced by mechanical ventilation in severe patients and improve their prognosis significantly compared with ACEI. To examine the advantages of ARB over ACEI on hypertensive COVID-19 patients, retrospective case-control studies comparing the clinical outcomes for COVID-19 patients receiving ARB or ACEI treatment is strikingly needed in order to provide guidance for the clinical application.

• Authors: Hong-Jin Zhao, Yan Li, De-Yu Wang, Hai-Tao Yuan
• Journal: Journal of cellular and molecular medicine (J Cell Mol Med) Vol. 25 Issue 23 Pg. 11031-11034 (12 2021) ISSN: 1582-4934 [Electronic] England
• PMID: 34766437 (Publication Type: Letter, Research Support, Non-U.S. Gov't)
• Copyright: © 2021 The Authors. Journal of Cellular and Molecular Medicine published by Foundation for Cellular and Molecular Medicine and John Wiley & Sons Ltd.

Chemical References

• Angiotensin II Type 2 Receptor Blockers
• Angiotensin-Converting Enzyme Inhibitors

Topics

• Angiotensin II Type 2 Receptor Blockers (administration & dosage)
• Angiotensin-Converting Enzyme Inhibitors (administration & dosage)
• Humans
• Hypertension (drug therapy)
• COVID-19 Drug Treatment