Given the recent Covid pandemic 19 Various news has emerged regarding what is good or what can cause more serious symptoms when infected with the SARS-cov-2 virus.. Particularly relevant to the hypertensive community is the fact that it has been proven that the virus binds to a protein found on the surface of various cells in our body and that, through this union, the virus can then enter the cell and subsequently reproduce.
To understand why the alarm has been generated, First it is important to understand which cell protein the virus binds to.. It is the Angiotensin Converting Enzyme of the type 2 (ECA2) (see figure). This protein in a normal person is expressed in low amounts, and its function is to generate a small peptide that lowers blood pressure and is called Angiotensin. 1-7.
In addition to this protein, there is a second enzyme called Angiotensin Converting Enzyme. (ECA, It differs from the previous one because it does not have the “2”) which fulfills the function of generating a peptide different from the previous one only in one amino acid, to angiotensin II, but that generally performs an opposite function, it is worth saying, increases the pressure.
One of the reasons why a person may be hypertensive is because ACE activity is increased. This causes our body to produce more angiotensin II.. This peptide binds to its receptor called the Angiotensin II Receptor., type 1 causing an increase in water and sodium retention and a contraction of blood vessels leading to an increase in blood pressure.
To avoid this increase in pressure, doctors may prescribe converting enzyme inhibitors (also known as ACEI, Many of the trade names of these drugs end in “pril.”) or else, angiotensin II type receptor antagonists 1 (which are also known as ARAII and whose trade names in many cases end in “sartan”).
These drugs, in addition to inhibiting ACE or blocking the Angiotensin II receptor,, type 1 in the cell, have the secondary effect of stimulating the expression of ACE2. Based on this fact, scientists Lei Fang, George Karakiulakis, and Michael Roth published in The Lancet magazine on 11 of March of 2020, a letter in which they pointed out that it was possible that those people with increased expression of ACE2 could receive a greater burden of the coronavirus, however, This hypothesis has not been proven or refuted to date..
This same question was addressed by another group of researchers led by Stefan Osswald, in Switzerland those who propose, in his article published in the European Heart Journal, he 18 March of this year, that the aforementioned drugs could reduce damage to the lung and other organs and thus allow hypertensive patients to be in a better state when facing coronavirus infection..
Because there is still no clinical evidence regarding these hypotheses, The different Medical Societies in the world – including the Chilean Hypertension Society – have recently recommended continuing treatments with ARBs and ACEIs., since there is abundant evidence that these drugs reduce deaths from cardiovascular diseases, cerebrovascular and renal.
Column of Dr.. Victoria Velarde.
Chilean Society of Hypertension