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SARS-CoV-2 and hypertension

Briyanth Ravichandran1, Daniela Grimm1,2, Marcus Krüger2

  • 1Department of Biomedicine, Aarhus University, Aarhus, Denmark.

Physiological Reports
|June 14, 2021
PubMed

Insights

Hypertension (HT) exacerbates COVID-19 severity by disrupting the Renin-Angiotensin-Aldosterone System (RAAS). SARS-CoV-2 infection downregulates ACE2, a key RAAS regulator, impacting blood pressure and disease outcomes.

Area of Science:

  • Cardiovascular Medicine
  • Infectious Diseases
  • Molecular Biology

Background:

  • Hypertension (HT) is a major global health burden and risk factor for cardiovascular diseases, contributing to millions of deaths annually.
  • The Renin-Angiotensin-Aldosterone System (RAAS) is crucial for blood pressure regulation, involving counter-regulatory axes.
  • Angiotensin-converting enzyme 2 (ACE2) plays a vital role in balancing the RAAS and serves as the entry receptor for SARS-CoV-2.

Purpose of the Study:

  • To review the pathophysiological effects of COVID-19 in relation to hypertension.
  • To focus on the role of the RAAS and the MAS receptor in COVID-19 and HT.
  • To elucidate the mechanisms linking SARS-CoV-2 infection, RAAS dysregulation, and HT severity.

Main Methods:

  • Literature review of existing studies on COVID-19, hypertension, and the RAAS.
  • Analysis of the interaction between SARS-CoV-2 and the ACE2 receptor.
  • Examination of the impact of SARS-CoV-2 on RAAS components and function.

Main Results:

  • Hypertension is a significant risk factor for severe COVID-19 outcomes and mortality.
  • SARS-CoV-2 infection can lead to the downregulation of ACE2, causing RAAS dysregulation.
  • The interaction between SARS-CoV-2 and ACE2 impacts cardiovascular function and disease progression.

Conclusions:

  • The RAAS plays a critical role in the pathophysiology of COVID-19, particularly in hypertensive patients.
  • Dysregulation of the RAAS by SARS-CoV-2 contributes to increased disease severity.
  • Further research is essential to fully understand the complex interplay between COVID-19, hypertension, and the RAAS.

Keywords:
COVID-19MAS-receptorSARS-CoV-2hypertensionrenin-angiotensin-aldosterone system

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