September 15, 2021
Renin Angiotensin Aldosterone System Inhibitors (ACE-I and ARB)
BACKGROUND:
ACE cleaves C-terminal peptides on angiotensin I, converting it to angiotensin II, and thus increases blood pressure in two ways: vasoconstriction and stimulation of the release of aldosterone, which increases the retention of water and sodium. ACE-I, ARB’s and DRI’s block this process.
ACE Inhibitors
Angiotensin II Receptor Blockers (ARBs)
benazepril (Lotensin)
candesartan (Atacand)
captopril (Capoten)
eprosartan (Tevetan)
enalapril (Vasotec)
irbesartan (Avapro)
fosinopril (Monopril)
losartan (Cozaar)
lisinopril (Prinivil, Zestril)
olmesartan (Benicar)
perindopril (Aceon)
telmisartan (Micardis)
quinapril (Accupril)
valsartan (Diovan)
ramipril (Altace)
trandolapril (Mavik)
Direct Renin Inhibitor: aliskiren (Tekturna)
DISCUSSIONS:
CONCERNS:
Considering that angiotensin receptor blockers and ACE inhibitors (ACEIs) are purported to upregulate the expression of ACE2 in animal studies, there may be a concern about whether these drugs may increase COVID-19 susceptibility and severity. ACE inhibitors and ARBs do not act on ACE2, the protein that acts as a SARS-CoV-2 receptor, and treatment with ACE inhibitors or ARBs does not appear to result in increased ACE2 expression.1
References: