The Role of Angiotensin Receptor Blockers in Patients with Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema

Background and Aims: Despite well developed guidelines in the management of ST elevation myocardial infarction, registries worldwide have demonstrated incomplete implementation of evidence-based recommendations. Our study aims to assess the adherence of our practices to the recommended clinical guidelines, which is based on the discharge prescription in Shahid Gangalal National Heart Centre. Methods: Medical records of 495 ST elevation myocardial infarction patients discharged from our centre in between January 2012 to December 2012 were retrospectively reviewed. Results: Among the 495 patients included in this study, 372 (75.1%) were males and 123 (24.9%) were females. The mean age was 56.9±12.4 years. Aspirin, Clopidrogel and statin were prescribed in more than 95% of the patients. Angiotensin Converting Enzyme inhibitor/ Angiotensin Receptor blockers was prescribed more often than β-blockers. Only a small numbers of patients were discharged without Angiotensin Converting Enzyme inhibitor /Angiotensin Receptor Blockers or β-blockers. Conclusions: Usage of Aspirin, clopidogrel, statins, beta blockers and Angiotensin Converting Enzyme inhibitor/ Angiotensin Receptor Blockers s is comparable to international studies. We still need some effort to increase improve our prescription rate of β-blockers and Angiotensin Converting Enzyme inhibitor/ Angiotensin Receptor Blockers. DOI: http://dx.doi.org/10.3126/njh.v11i1.10981 Nepalese Heart Journal 2014;11(1): 45-48

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Pengaruh penggunaan angiotensin converting enzyme inhibitor (ACEI) dan angiotensin receptor blocker (ARB) pada pasien coronavirus disease 2019 (covid-19) dengan hipertensi

e-CliniC ◽

10.35790/ecl.v9i1.31963 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Briando Linelejan ◽

Octavianus Umboh ◽

Frans E. N. Wantania

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Literature Review ◽

Angiotensin Converting Enzyme ◽

Angiotensin Converting Enzyme Inhibitor ◽

Enzyme Inhibitor ◽

Angiotensin Receptor Blockers ◽

Converting Enzyme ◽

Angiotensin Receptor ◽

Converting Enzyme Inhibitor ◽

Receptor Blockers

Abstract: Hypertension is considered as one of the highest death-caused disease worldwide. Coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) most frequently occurred in elderly and those who had comorbid diseases, one of them is hypertension. The first line drugs that are usually used in hypertension are angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs). It is assumed that these drugs coud influence the progress of COVID-19 due to the similiar target receptor. This study was aimed to evaluate the influence of ACEIs and ARBs to patients with COVID-19 and hypertension. This was a literature review study using literatures published in medical journal databases such as PubMed and ClinicalKey. The results obtained 10 literatures that fulfilled the inclusion and exclusion criteria. These ten literatures stated that there was no influence of using ACEIs and ARBs in COVID-19 patients. In conclusion, ACEIs and ARBs do not influence the mortality or progresivity of COVID-19 disease and are suggested to be consumed continually.Keywords: ACEIs, ARBs, COVID-19, hypertension, hypertension in COVID-19 Abstrak: Hipertensi merupakan salah satu penyebab kematian tertinggi di dunia. Pandemik coronavirus disease 2019 (COVID-19) dengan severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sebagai etiologinya kebanyakan terjadi pada usia tua serta yang memiliki penyakit komorbid, salah satu yang tersering ialah hipertensi. Obat lini pertama yang biasa digunakan untuk hipertensi yaitu angiotensin converting enzyme inhibitor (ACEI) dan angiotensin receptor blockers (ARB) dikatakan dapat memengaruhi perkembangan penyakit COVID-19 karena memiliki reseptor atau tempat kerja yang mirip. Penelitian ini bertujuan untuk mengevaluasi pengaruh penggunaan ACEI dan ARB pada pasien COVID-19 dengan hipertensi. Jenis penelitian ialah literature review dengan menggunakan literatur-literatur yang dipublikasi dalam database jurnal kedokteran PubMed dan ClinicalKey sesuai dengan kriteria inklusi dan eksklusi penelitian. Hasil penelitian mendapatkan 10 literatur; kesemuanya menyatakan bahwa tidak terdapat pengaruh penggunaan ACEI dan ARB terhadap pasien COVID-19. Simpulan penelitian ini penggunaan ACEI dan ARB tidak memengaruhi mortalitas maupun progresivitas penyakit COVID-19 dan disarankan untuk tetap dilanjutkan.Kata kunci: ACEI, ARB, COVID-19, hipertensi, hipertensi pada COVID-19

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Angioedema induced by angiotensin-converting enzyme inhibitors: an analysis of hospitalizations during the COVID-19 pandemic

Rossiiskii Allergologicheskii ZHurnal ◽

10.36691/rja1460 ◽

2021 ◽

Author(s):

Tatsiana М. Sabalenka ◽

Volha V. Zakharava ◽

Natallia R. Prakoshyna

Keyword(s):

Angiotensin Converting Enzyme ◽

Enzyme Inhibitors ◽

Enzyme Inhibitor ◽

Angiotensin Receptor Blockers ◽

Angiotensin Converting Enzyme Inhibitors ◽

Converting Enzyme ◽

Angiotensin Receptor ◽

Converting Enzyme Inhibitors ◽

Converting Enzyme Inhibitor ◽

Receptor Blockers

Backgraund: The pathogenesis of angioedema induced by angiotensin-converting enzyme inhibitors is based on the accumulation of bradykinin as a result of angiotensin-converting enzyme blockade. The SARS-CoV-2 virus by binding to the angiotensin-converting enzyme 2 receptor, may inhibit its production, which in turn leads to an increase in bradykinin levels. Thus, infection with SARS-CoV-2 may be a likely trigger for the development of angioedema. Aims: to analyze the cases of hospitalizations of patients with angioedema associated with the use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers during the COVID-19 pandemic. Materials and methods: a retrospective analysis of the medical records of inpatient patients admitted to the Vitebsk Regional Clinical Hospital in May-December 2020 with isolated (without urticaria) angioedema while receiving angiotensin-converting enzyme inhibitors or angiotensin receptor blockers was performed. All patients received smears from the naso- and oropharynx for COVID-19 by polymerase chain reaction. Results: there were admitted 15 patients (9 men and 6 women) aged 44-72 years for emergency indications, which was 53.6% among all patients with isolated angioedema. In two cases, a concomitant diagnosis of mild COVID-19 infection was established with the predominance symptoms of angioedema in the clinical picture with localization in the face, tongue, sublingual area, soft palate. All patients had a favorable outcome of the disease. Conclusions: patients with аngiotensin-converting enzyme inhibitor-induced angioedema may need to be hospitalized to monitor upper respiratory tract patency. There were cases of a combination of аngiotensin-converting enzyme inhibitor-induced angioedema and mild COVID-19 infection. Issues requiring additional research: the effect of SARS-CoV-2 infection on the levels of bradykinin and its metabolites; the trigger role of COVID-19 infection in the development of angioedema in patients receiving angiotensin-converting enzyme inhibitors/angiotensin receptor blockers; recommendations for the management of patients with аngiotensin-converting enzyme inhibitor-induced angioedema and a positive result for COVID-19.

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