Use of ACE inhibitors, ARBs not tied to higher plasma ACE2 concentrations in those with heart failure
TUESDAY, May 12, 2020 (HealthDay News) — Among patients with heart failure, men have higher plasma concentrations of angiotensin-converting enzyme 2 (ACE2), while neither use of angiotensin-converting enzyme (ACE) inhibitors nor angiotensin receptor blockers (ARBs) are associated with increased plasma ACE2 concentrations, according to a study published online May 10 in the European Heart Journal.
Noting that higher ACE2 concentrations may lead to increased vulnerability to severe acute respiratory coronavirus 2 (SARS-CoV-2) in patients on renin-angiotensin-aldosterone system inhibitors, Iziah E. Sama, Ph.D., from the University of Groningen in the Netherlands, and colleagues measured ACE2 concentrations in an index cohort (1,485 men and 537 women with heart failure) and validated the results in a validation cohort (1,123 men and 575 women).
The researchers found that in both cohorts, the strongest predictor of elevated ACE2 concentration was male sex (estimate, 0.26 and 0.19, respectively). Use of ACE inhibitors, ARBs, or mineralocorticoid receptor antagonists (MRAs) did not independently predict plasma ACE2 in the index cohort. In the validation cohort, ACE inhibitor and ARB use independently predicted lower plasma ACE2 (estimate, −0.17 and −0.15, respectively), while MRA use was an independent predictor of higher plasma ACE2 concentrations (estimate, 0.11).
“Patients receiving ACE inhibitors or ARBs did not have higher plasma concentrations of ACE2, and any effect of MRAs was small and inconsistent, supporting the continued use of these agents in patients with heart failure during the current SARS-CoV-2 pandemic,” the authors write.
Several authors disclosed financial ties to the pharmaceutical and medical device industries.
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