scholarly journals Strong suppression of the renin–angiotensin system has a renal-protective effect in hypertensive patients: High-dose ARB with ACE inhibitor (Hawaii) study

2010 ◽  
Vol 33 (11) ◽  
pp. 1150-1154 ◽  
Author(s):  
Mitsuru Ohishi ◽  
Yasushi Takeya ◽  
Yuji Tatara ◽  
Koichi Yamamoto ◽  
Miyuki Onishi ◽  
...  
Keyword(s):  
Protective Effect ◽  
Ace Inhibitor ◽  
Renin Angiotensin System ◽  
High Dose ◽  
Strong Suppression ◽  
Angiotensin System ◽  
Hypertensive Patients ◽  
Renin Angiotensin

scholarly journals Mortality and Pre‐Hospitalization use of Renin‐Angiotensin System Inhibitors in Hypertensive COVID‐19 Patients

2020 ◽  
Vol 9 (21) ◽  
Author(s):  
Chen Chen ◽  
Feng Wang ◽  
Peng Chen ◽  
Jiangang Jiang ◽  
Guanglin Cui ◽  
...  
Keyword(s):  
Protective Effect ◽  
Angiotensin Receptor Blockers ◽  
Meta Analysis ◽  
Renin Angiotensin System ◽  
Published Data ◽  
Converting Enzyme Inhibitors ◽  
Angiotensin System ◽  
Hypertensive Patients ◽  
Renin Angiotensin ◽  
Ras Inhibitors

Abstract Background There has been significant controversy regarding the effects of pre‐hospitalization use of renin‐angiotensin system (RAS) inhibitors on the prognosis of hypertensive COVID‐19 patients. Methods and Results We retrospectively assessed 2,297 hospitalized COVID‐19 patients at Tongji Hospital in Wuhan, China, from January 10 th to March 30 th , 2020; and identified 1,182 patients with known hypertension on pre‐hospitalization therapy. We compared the baseline characteristics and in‐hospital mortality between hypertensive patients taking RAS inhibitors (N=355) versus non‐RAS inhibitors (N=827). Of the 1,182 hypertensive patients (median age 68 years, 49.1% male), 12/355 (3.4%) patients died in the RAS inhibitors group vs. 95/827 (11.5%) patients in the non‐RAS inhibitors group (p<0.0001). Adjusted hazard ratio for mortality was 0.28 (95% CI 0.15‐0.52, p<0.0001) at 45 days in the RAS inhibitors group compared with non‐RAS inhibitors group. Similar findings were observed when patients taking angiotensin receptor blockers (N=289) or angiotensin converting enzyme inhibitors (N=66) were separately compared with non‐RAS inhibitors group. The RAS inhibitors group compared with non‐RAS inhibitors group had lower levels of C‐reactive protein (median 13.5 vs. 24.4 pg/mL; p=0.007) and interleukin‐6 (median 6.0 vs. 8.5 pg/mL; p=0.026) on admission. The protective effect of RAS inhibitors on mortality was confirmed in a meta‐analysis of published data when our data were added to previous studies (odd ratio 0.44, 95% CI 0.29–0.65, p<0.0001). Conclusions In a large single center retrospective analysis we observed a protective effect of pre‐hospitalization use of RAS inhibitors on mortality in hypertensive COVID‐19 patients; which might be associated with reduced inflammatory response.

scholarly journals Acute effects of renin-angiotensin system blockade on arterial function in hypertensive patients

2007 ◽  
Vol 21 (8) ◽  
pp. 654-663 ◽  
Author(s):  
K A Aznaouridis ◽  
K S Stamatelopoulos ◽  
E N Karatzis ◽  
A D Protogerou ◽  
C M Papamichael ◽  
...  
Keyword(s):  
Renin Angiotensin System ◽  
Acute Effects ◽  
Arterial Function ◽  
Angiotensin System ◽  
Hypertensive Patients ◽  
Renin Angiotensin

scholarly journals Impact of Treatment with Renin–Angiotensin System Inhibitors on Clinical Outcomes in Hypertensive Patients Hospitalized with COVID-19

2020 ◽  
Vol 27 (6) ◽  
pp. 561-568 ◽  
Author(s):  
Martin Negreira-Caamaño ◽  
Jesus Piqueras-Flores ◽  
Jorge Martínez-DelRio ◽  
Patricia Nieto-Sandoval-Martin-DeLaSierra ◽  
Daniel Aguila-Gordo ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Renin Angiotensin System ◽  
Angiotensin System ◽  
Hypertensive Patients ◽  
Renin Angiotensin

scholarly journals Role of the renin-angiotensin system in the development of severe COVID-19 in hypertensive patients

2020 ◽  
Vol 319 (4) ◽  
pp. L596-L602
Author(s):  
Rodrigo Pacheco Silva-Aguiar ◽  
Diogo Barros Peruchetti ◽  
Patricia Rieken Macedo Rocco ◽  
Alvin H. Schmaier ◽  
Patrícia Machado Rodrigues e Silva ◽  
...  
Keyword(s):  
Critical Role ◽  
Renin Angiotensin System ◽  
Multiple Organ ◽  
Ang Ii ◽  
Angiotensin System ◽  
Hypertensive Patients ◽  
Renin Angiotensin ◽  
Therapeutic Benefits ◽  
Global Threat

A new form of severe acute respiratory syndrome (SARS) caused by SARS-coronavirus 2 (CoV-2), called COVID-19, has become a global threat in 2020. The mortality rate from COVID-19 is high in hypertensive patients, making this association especially dangerous. There appears to be a consensus, despite the lack of experimental data, that angiotensin II (ANG II) is linked to the pathogenesis of COVID-19. This process may occur due to acquired deficiency of angiotensin-converting enzyme 2 (ACE2), resulting in reduced degradation of ANG II. Furthermore, ANG II has a critical role in the genesis and worsening of hypertension. In this context, the idea that there is a surge in the level of ANG II with COVID-19 infection, causing multiple organ injuries in hypertensive patients becomes attractive. However, the role of other components of the renin angiotensin system (RAS) in this scenario requires elucidation. The identification of other RAS components in COVID-19 hypertension may provide both diagnostic and therapeutic benefits. Here, we summarize the pathophysiologic contributions of different components of RAS in hypertension and their possible correlation with poor outcome observed in hypertensive patients with COVID-19.

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