School of Nursing and Public Health, Department of Family Medicine, University of KwaZulu-Natal, Durban, South Africa.
School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa.
Curr Hypertens Rep. 2021 Mar 25;23(4):17. doi: 10.1007/s11906-021-01134-9.
This review focuses on the associations between the renin-angiotensin system, hypertension, and severe acute respiratory syndrome (SARS-COV-2) infection. A brief prelude on the current state of affairs with COVID-19 is given. In addition to an overview of ACE2, Ang II, and Ang (1-7), this review presents a brief statement on hypertension, including the function of enzymes involved in the control of hypertension, cardiovascular disease, diabetes mellitus, and other malignancies.
There is currently no data in support of the concerns raised with the use of ACEIs/ARBs. Many researchers have voiced concerns that the use of ACEIs and ARBs may increase tissue ACE2 levels. These researchers therefore recommend that individuals on ACEIs/ARB's medications withhold such antihypertensive drugs, unless advised by their physicians to do so. SARS-CoV-2 uses ACE2 receptors as the port of entry to human hosts. ACE2 and ACE are different enzymes and ACE inhibitors do not inhibit ACE2. Therefore, the use of ARB's or ACEIs should not be discontinued if an individual is infected by SARS-CoV-2. Further studies are required to investigate the effect of ACEIs and ARBs on ACE2 expression and COVID-19.
本文重点关注肾素-血管紧张素系统、高血压和严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染之间的关联。本文简要介绍了当前的 COVID-19 现状。除了对 ACE2、血管紧张素 II（Ang II）和血管紧张素（1-7）的概述外，本文还简要介绍了高血压，包括参与高血压、心血管疾病、糖尿病和其他恶性肿瘤控制的酶的功能。
目前尚无数据支持使用 ACEIs/ARBs 引起的担忧。许多研究人员担心使用 ACEIs 和 ARBs 可能会增加组织 ACE2 水平。因此，这些研究人员建议正在服用 ACEIs/ARB 类药物的个体，如果医生没有建议，应停止使用此类降压药物。SARS-CoV-2 利用 ACE2 受体作为进入人体宿主的门户。ACE2 和 ACE 是两种不同的酶，ACE 抑制剂不抑制 ACE2。因此，如果个体感染了 SARS-CoV-2，不应停用 ARB 或 ACEI。需要进一步研究 ACEIs 和 ARBs 对 ACE2 表达和 COVID-19 的影响。
