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Is the use of RAS inhibitors safe in the current era of COVID-19 pandemic?

 Sungha Park  ;  Hae Young Lee  ;  Eun Joo Cho  ;  Ki Chul Sung  ;  Juhan Kim  ;  Dae-Hee Kim  ;  Sang-Hyun Ihm  ;  Kwang-Il Kim  ;  Il-Suk Sohn  ;  Wook-Jin Chung  ;  Hyeon Chang Kim  ;  Sung Kee Ryu  ;  Wook Bum Pyun  ;  Jinho Shin  ;  Korean Society of Hypertension 
 Clinical Hypertension, Vol.26 : 11, 2020-05 
Journal Title
 Clinical Hypertension 
Issue Date
2019 novel coronavirus ; ACE inhibitor ; ACE2 ; Angiotensin receptor blocker ; Antihypertensive drugs ; COVID-19 ; Hypertension ; Infection ; Pandemic ; SARS ; SARS-CoV-2 ; Sepsis
Antihypertensive drugs are one of the most widely used pharmacologic agent in the world and it is predominantly used in the elderly subjects. Pneumonia is the most common cause of death in the extremely old subject. During infection and its complication such as sepsis, hypotension could be exacerbated by antihypertensive drugs because homeostasis mechanisms such as sodium balance, renin angiotensin aldosterone system and/or sympathetic nervous system can be mitigated by antihypertensive drug therapy. Severe Acute Respiratory Syndrome-Coronavirus-1 and 2 viral surface protein is known to attach angiotensin converting enzyme 2 (ACE2) on the cell membrane to facilitate viral entry into the cytoplasm. Despite the theoretical concerns of increased ACE2 expression by Renin-Angiotensin-Aldosterone system (RAS) blockade, there is no evidence that RAS inhibitors are harmful during COVID-19 infection and have in fact been shown to be beneficial in animal studies. Therefore, it is recommended to maintain RAS blockade during the current corona virus pandemic.
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyeon Chang(김현창) ORCID logo https://orcid.org/0000-0001-7867-1240
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
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