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[HTN big market] unscramble the hypertension under the new crown, such people should stop taking med

Issuing time:2020-10-24 11:34

When high blood pressure meets holidays, how to balance diet and exercise?

When high blood pressure meets new coronary pneumonia by chance, how to solve it with medication and medical treatment?

Corona Virus Disease 2019 (COVID-19) is a pneumonia caused by a new coronavirus (SARS-CoV-2) invading the human respiratory tract that appeared at the end of 2019.

As early as the beginning of the epidemic, patients with chronic diseases have received great attention from cardiovascular doctors.

Although all people of the new coronavirus are susceptible, patients with chronic diseases are more likely to develop severe pneumonia after infection. After infection, the onset is more rapid, the condition deteriorates faster, and the treatment is more difficult.

As people's understanding of the new coronavirus gradually deepens, studies have found that, similar to the previous SARS virus, COVID-19 also invades the human body through angiotensin converting enzyme 2 (ACE2) that binds to human type II alveolar cells.

To answer this question, we must first sort out the following questions:

1、How is ACE2 distributed in the body?

The distribution of ACE2 in our body has a high degree of tissue specificity. It is mainly distributed on alveolar epithelial cells, small intestine cells and vascular endothelial cells and smooth muscle cells of various organs throughout the body. Among them, the distribution of pulmonary microvascular endothelial cells is significantly higher than that of others. The microvascular endothelial cells of organ tissues. This result is consistent with the clinical manifestations and pathological results of new coronary pneumonia centering on lung injury.

2、Will the use of ACEI or AR

Reflexivity causes an increase in ACE2 expression, which makes it easier for viruses to invade cells. At the same time, ACEI and ARB drugs can block the feedback increase of ACE2 in the lungs, and their effect on improving lung inflammation can counteract their role in mediating viral infections.

3、Will changes in the expression of ACE2 lead to increased susceptibility to SARS-COV-2 virus?

The new coronavirus can enter the body through its surface spike protein (S protein) and ACE2 on the surface of lung cells. When high-risk hypertensive patients are first exposed to the new coronavirus, the new coronavirus uses its S protein to interact with the type II alveoli of high-risk hypertensive people. The epithelial cell ACE2 binds, the virus envelope fuses with the cell membrane, and the virus releases its genetic material into the cell, causing infection. Therefore, it is recommended that people with high blood pressure who have been in the epidemic area or in contact with infected people should be vigilant.

For hypertensive patients who have been infected with the new coronavirus, there is no evidence that ACEI or ARB will cause special damage to SARS-COV-2 infection. Therefore, for hypertensive patients who have been infected with the new coronavirus, if they have taken ACEI or ARB for blood pressure treatment, they can still continue to take it.

In general, for hypertensive patients taking ACEI and ARB drugs for blood pressure reduction, if they are not close contacts of SARS-COV-2, they can still continue to take these drugs; if they are close contacts, it is recommended to use them with caution ; For patients with pneumonia already infected with SARS-COV-2, it should continue to be used.

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