from The Lancet - hypothesis - people on ACE inhibitors at risk for higher infection

[womanofthehills]

Last edited Sun Mar 15, 2020, 08:27 PM - Edit history (1)

No problem with calcium channel blockers.

Human pathogenic coronaviruses (severe acute respiratory syndrome coronavirus [SARS-CoV] and SARS-CoV-2) bind to their target cells through angiotensin-converting enzyme 2 (ACE2), which is expressed by epithelial cells of the lung, intestine, kidney, and blood vessels.4

The expression of ACE2 is substantially increased in patients with type 1 or type 2 diabetes, who are treated with ACE inhibitors and angiotensin II type-I receptor blockers (ARBs).4
Hypertension is also treated with ACE inhibitors and ARBs, which results in an upregulation of ACE2.5
ACE2 can also be increased by thiazolidinediones and ibuprofen. These data suggest that ACE2 expression is increased in diabetes and treatment with ACE inhibitors and ARBs increases ACE2 expression. Consequently, the increased expression of ACE2 would facilitate infection with COVID-19. We therefore hypothesise that diabetes and hypertension treatment with ACE2-stimulating drugs increases the risk of developing severe and fatal COVID-1

9.

https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30116-8/fulltext - (link is not working - I posted article below)

[hlthe2b]

1. Ahh geez. This makes so much sense in a very nasty evolutionary way.

[still_one]

2. The link doesn't work. Second, it is a hypothesis, which has not been verified

[womanofthehills]

4. here is the whole article

[LisaL]

5. It's still a hypothesis and I have seen an article proposing an opposite hypothesis.

I would really like to know what is accurate but one needs data, not just a hypothesis.

[octoberlib]

8. I've seen articles on this as well.

[womanofthehills]

15. If ACE2 is the receptor for the virus and ACE inhibitors increase ACE2 receptors

it kind of makes sense

[still_one]

9. Thanks. However, no one should stop taking their ACE or ARB because of this hypothesis.

[womanofthehills]

11. One might want to switch to calcium channel blockers for a few months

or really work on getting their blood pressure down naturally - lose weight, take natural blood vessel dilators - l'arginine, magnesium, niacin, beets.

[womanofthehills]

6. Another interesting article about ACE2

Scientists figure out how new coronavirus breaks into human cells

Researchers led by Qiang Zhou, a research fellow at Westlake University in Hangzhou, China, have revealed how the new virus attaches to a receptor on respiratory cells called angiotensin-converting enzyme 2, or ACE2.

"If we think of the human body as a house and 2019-nCoV [another name for SARS-CoV-2] as a robber, then ACE2 would be the doorknob of the house's door. Once the S-protein grabs it, the virus can enter the house," Liang Tao, a researcher at Westlake University who was not involved in the new study, said in a statement

.

https://www.livescience.com/how-coronavirus-infects-cells.html

[octoberlib]

7. The test groups were small. I'm on Lisinopril but will wait for more evidence.

Some doctors Who've treated COVID patients have been critical of this finding.

[still_one]

10. There has to be a lot more evidence. Also, as with everything it is a matter of risk verses reward

[octoberlib]

12. Yes and I would never stop taking Lisinopril unless I was put on another class of drug,

like a calcium channel blocker

[womanofthehills]

13. The article says calcium channel blockers are a good substitute

Lisinopril makes me cough so bad I can't take it. I researched the side effects of Lisinopril and did not like how it changes the enzymes in your lungs.

[womanofthehills]

14. Can you post an article?

[Fiendish Thingy]

16. No scientific basis for this assertion

https://www.escardio.org/Councils/Council-on-Hypertension-(CHT)/News/position-statement-of-the-esc-council-on-hypertension-on-ace-inhibitors-and-ang

From the article:

Because of the social media-related amplification, patients taking these drugs for their high blood pressure and their doctors have become increasingly concerned, and, in some cases, have stopped taking their ACE-I or ARB medications.

This speculation about the safety of ACE-i or ARB treatment in relation to COVID-19 does not have a sound scientific basis or evidence to support it. Indeed, there is evidence from studies in animals suggesting that these medications might be rather protective against serious lung complications in patients with COVID-19 infection, but to date there is no data in humans.

The Council on Hypertension of the European Society of Cardiology wish to highlight the lack of any evidence supporting harmful effect of ACE-I and ARB in the context of the pandemic COVID-19 outbreak.

The Council on Hypertension strongly recommend that physicians and patients should continue treatment with their usual anti-hypertensive therapy because there is no clinical or scientific evidence to suggest that treatment with ACEi or ARBs should be discontinued because of the Covid-19 infection.

.

My wife is a medical technologist and reviewed both the OP link and this one.

Critical thinking skills are even more essential in these times...