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A new research paper, just out as of March 23rd, states that high blood pressure medications called ACE inhibitors negatively affect people with Covid 19 infections. James Diaz MD, of Louisiana State University Health Center, has proposed a possible explanation for the severe lung complications seen with some patients diagnosed with COVID-19. The paper states that there is a correlation between complications in the lungs and high blood pressure medication, specifically ACE inhibitors and ARB’s.

Specifics of the research paper

Both the SARS CoV-2 and the COVID-19 virus bind to receptor sites in the lower lungs of infected patients. These sites are called angiotensin converting enzyme 2 (ACE2) receptors. Viral pneumonia and respiratory failure may result in susceptible people after 10-14 days.

Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are highly recommended medications for patients with cardiovascular diseases. These include heart disease, high blood pressure, diabetes and chronic kidney disease, to name a few. Many of those who develop these diseases are older adults, who are prescribed these medications and take them every day.

Research in experimental models has shown an increase in the number of ACE2 receptors in the cardiopulmonary circulation after intravenous infusions of ACE inhibitors. Patients treated with ACEIs and ARBS will have increased numbers of ACE2 receptors in their lungs for Coronavirus proteins to bind to. Because of this, they may be at increased risk of severe disease outcomes due to SARS-CoV-2 infections (which is the official name for Covid 19). (1)

Why the infection rate is lower in children

The paper goes on to say that two mechanisms may protect children from COVID-19 infections. Children build up antibodies from the multiple childhood illness they contract. The antibodies from multiple upper respiratory tract infections, particularly from the alpha corona viruses that cause the common cold, are cross-protective.  Another is fewer ACE2 receptors in their lower respiratory tracts to attract the binding of proteins of beta corona viruses like SARS and Covid19. (1)

Dr O’s recommendation

What I have heard from other M.D.’s is that once you are on a respirator for more than a few days with Covid 19 infections, your chances of survival goes down substantially.

If you, your parents or anyone in your family are on high blood pressure medication (ACEI’s or ARB’s) please talk to your physician about it, and possibly show him/her this research paper. It may be possible to adjust your meds or even take you off for a time by working with your lifestyle/diet to keep your blood pressure manageable.

Full disclosure: I am a dentist and not licensed to give advice on high blood pressure, heart disease or Covid 19 infections, nor do I treat them. I am also not recommending that you go off your medications. For advice on this you should see a qualified medical practitioner.

If you have any questions about this post, or about dentistry in this new landscape of infectious disease, please reach out to us. Our preferred method of communication for questions is email. Please use this email: [email protected]

Above all else, stay safe and healthy. I am going to be writing about things you can do to stay healthy and strengthen your immune system, so stay tuned.

  1. ACE inhibitors and angiotensin receptor blockers may increase the risk of severe COVID-19, March 23, 2020, James Diaz MD. MHA. MPH & TM. Dr PH, Professor and Head of Environmental and Occupational Health Sciences, School of Public Health; Professor of Anesthesiology, School of Medicine, Louisiana State University Health Sciences Center (LSUHSC),      New Orleans, Louisiana, USA.