Hypertension and nephrology

[Hypertension and Covid-19 - part II.]

SZÉKÁCS Béla1, KÉKES Ede2, NAGY Judit3, KOVÁCS Tibor3

NOVEMBER 04, 2020

Hypertension and nephrology - 2020;24(05)

DOI: https://doi.org/10.33668/hn.24.023

[The authors review those components and mechanisms in the two major regulatory systems of circulation and inflammation-coagulation whose internal balance and interactions are pathologically altered during SARS-CoV-2 infection, thereby enhancing lung and systemic inflammation threatening to enter into severe clinical condition. They examine the question of how – in addition to potentially promoting the coronavirus cellular entry and penetration – the RAS inhibitor therapy affects these changes and whether can be supposed difference between the anti-/pro-inflammatory influence of ACEi and ARB treatment of old hypertensive patients representing a remarkably high proportion of victims in COVID-19 epidemic. The paper is focussing to the pathomechanical background of inflammation beyond the direct immunological response to the infection: to the significance of immunological alterations characterizing old hypertensive patients also in basic condition, and to the key components as angiotensin II, ACE2, angiotensin1-7, bradykinin, ARB and ACEi. In conclusion a consideration on optimal point of action is offered in RASi treated and SARS-CoV-2 infected (old) hypertensive patients.]

AFFILIATIONS

  1. Szent Imre Egyetemi Oktatókórház, Geriátriai és Gerontopszichiátriai Rehabilitációs Osztály; Semmelweis Egyetem, Belgyógyászati és Onkológiai Klinika, Geriátriai Tanszéki Csoport, Budapest
  2. Pécsi Tudományegyetem, Orvostudományi Kar, Klinikai Központ, Kardiológiai Tanszék, Pécs
  3. Pécsi Tudományegyetem, Orvostudományi Kar, Klinikai Központ, II. Sz. Belgyógyászati Klinika és Nefrológiai, Diabetológiai Centrum, Pécs

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