Posted on Apr 01, 2020, 3 p.m.
Article courtesy of: Charles B. Simone, M.MS, M.D
DRUGS INCREASE ACE2 THAT IS NEEDED BY SARS-CoV-2 (COVID-19 Coronavirus) TO ATTACH AND INFECT CELLS of the lung, intestine, kidney, blood vessel. The more ACE2, the more infection. This may be the reason why the elderly who are treated with these drugs, have a greater risk of death / severe side effects.
A joint opinion statement about this topic was issued on March 17, 2020 by the American College Cardiology, American Heart Association, and the Heart Failure Society of America:
"The continued highest standard of care for cardiovascular disease patients diagnosed with COVID-19 is top priority, but there are no experimental or clinical data demonstrating beneficial or adverse outcomes among COVID-19 patients using ACE-I or ARB medications," said Richard J. Kovacs, MD, FACC. "We urge urgent, additional research that can guide us to optimal care for the millions of people worldwide with cardiovascular disease and who may contract COVID-19. These recommendations will be adjusted as needed to correspond with the latest research."
“In the event patients with cardiovascular disease are diagnosed with COVID-19, individualized treatment decisions should be made according to each patient's hemodynamic status and clinical presentation."
Dr Simone's Recommendation March 18, 2020:
Speak with your prescribing physician about this to determine what is best for you.
We should always decrease risk while maintaining good blood pressure and diabetes control. Diabetes (34 million Americans) and certain medicines (ACE inhibitors, ARBs, ibuprofen, thiazolidinediones) taken by tens of millions of Americans increase the ACE2 receptors that allow the virus to attach and infect cells. Once these patients are infected, it may be too late. Therefore, physicians should consider modifying these medications or substituting them with calcium channel blockers or other diabetes medicines to maintain good blood pressure control and blood glucose control for a temporary period of time until the pandemic wanes.
Examples of (ACE) Angiotensin Converting Enzyme Inhibitors:
- Benazepril (Lotensin, Lotensin Hct)
- Captopril (Capoten)
- Enalapril (Vasotec)
- Fosinopril (Monopril)
- Lisinopril (Prinivil, Zestril)
- Moexipril (Univasc)
- Perindopril (Aceon)
- Quinapril (Accupril)
- Ramipril (Altace)
- Trandolapril (Mavik)
Examples of (ARBS) Angiotensin II Receptor Blockers:
- Azilsartan (Edarbi)
- Candesartan (Atacand)
- Irbesartan (Avapro)
- Losartan (Cozaar)
- Olmesartan (Benicar)
- Telmisartan (Micardis)
- Valsartan (Diovan)
Examples of Thiazolidinediones:
- Rosiglitazone (Avandia)
- Pioglitazone (Actos)
Examples of Antihypertensive calcium channel blockers that don’t increase ACE2 that may be an alternative:
- Norvasc (Amlodipine)
- Plendil (Felodipine)
- DynaCirc (Isradipine)
- Cardene (Nicardipine)
- Procardia XL, Adalat (Nifedipine)
- Cardizem, Dilacor, Tiazac, Diltia XL, (Diltiazem)
- Sular (Nisoldipine)
- Isoptin, Calan, Verelan, Covera-HS (Verapamil)
Article courtesy of: Charles B. Simone, M.MS., M.D.
Charles B. Simone, M.MS., M.D. is an Internist (Cleveland Clinic 1975-77), Medical Oncologist (National Cancer Institute 1977-82), Tumor Immunologist (NCI 1977-82), and Radiation Oncologist (University of Pennsylvania 1982-85), and is the Founder of the Simone Protective Cancer Institute (1980). He wrote Cancer and Nutrition, A Ten Point Plan for Prevention and Cancer Life Extension (1981, third revision 2005), The Truth About Breast Health - Breast Cancer (2002), The Truth About Prostate Health - Prostate Cancer (2005), How To Save Yourself From A Terrorist Attack (2001), Nutritional Hydration, Medical Strategy for Military and Athlete Warriors (2008), helped organize the Office of Alternative Medicine, NIH (1992), helped write the Dietary Supplement, Health and Education Act of 1994, helped win landmark cases against the FDA by showing they violated the First and Fifth Amendment rights of Americans, helped introduce the Health Freedom Protection Act of 2005 (H.R. 2117), was bestowed the first Bulwark of Liberty Award in 2001 by the American Preventive Association, the James Lind Scientific Achievement Award in 2004, and in 2014 the Sacred Fire of Liberty organization bestowed upon him The First Amendment Hall of Fame, Excellence in Integrative Medicine, Excellence in Medical Research, and Excellence in Health Product Innovation. While at the National Institutes of Health and Bethesda Naval Hospital as Commander, Dr Simone discovered the fundamental mechanism of how complement proteins and human white cells kill by forming pores in the membrane. This provided the foundation for Anthrax killing. He discovered how adriamycin kills cancer cells; and developed the idea of splicing monoclonal antibodies to killing cells that seek out and destroy cancer cells - this he calls, directed effector cells. He continues bench research with the NCI showing that proteomic patterns can diagnose specific cancers at earlier stages than we are currently able to do (Lancet Feb 2002, JNCI Nov 2002), as well as clinical research that shows in 61 human studies Antioxidants and Other Nutrients Do Not Interfere with Chemotherapy or Radiation, and Can Increase Kill, Decrease Side Effects, and Increase Survival (Altern Ther Health Med. 2007. 13(1):22-28; and 13(2):40-46; JNCI Nov 2008). He founded the Simone Healthy Start Prevention Program in 1980. Consults for heads of the state, and advises governments regarding healthcare, as well as coaching world class endurance athletes.
 Wan Y et al. Receptor recognition by novel coronavirus from Wuhan: An analysis based on decade-long structural studies of SARS. J Virology.2020; (published online Jan 29). DOI:10.1128/JVI.00127-20
 Li XC et al. The vasoprotective axes of the renin-angiotensin system: physiological relevance and therapeutic implications in cardiovascular, hypertensive and kidney diseases. Pharmacol Res.2017; 125: 21-38.
 Fang L, et al. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? Lancet Respiratory Medicine. March 11, 2020. https://doi.org/10.1016/S2213-2600(20)30116-8