ASEAN FEDERATION OF CARDIOLOGY
c/o National Heart Association of Malaysia
Heart House, D-13A-06, Menara Suezcap 1, KL Gateway, No.2 Jalan Kerinchi, Gerbang Kerinchi Lestari
59200 Kuala Lumpur, MALAYSIA
Tel: 603-7931 7900 Fax: 603-7932 1400
AFC Position Statement on ACE-I and ARBs use related to COVID-19 outbreak
Scientists have shown that COVID-19 glycoprotein binds to the cell membrane protein angiotensin-converting enzyme 2 (ACE-2) to enter human cells. The structure of the ACE-2 receptor protein is on the surfaces of the respiratory cells. To COVID-19, ACE-2 is a receptor, an entranceway, in the airways and alveoli, as well as in blood vessel linings. Hypothetically, treatment with ACE-I or ARBs could possibly amplify the effects of COVID-19 and that patients on these antihypertensives may fare worse. Some medical professionals have become concerned and patients have possibly stopped taking ACE-I or ARBs medication.
However, there is no clinical evidence or trial in human to show that we should discontinue ACE inhibitors or ARBs as stopping these drugs could precipitate acute events and worsened cardiac failure. There is currently no guideline that stated otherwise. The AFC (ASEAN Federation of Cardiology) would like to emphasize that this speculation of the unsafely of ACE-I or ARBs pertinent to COVID-19 is not evidence-based.
The American Heart Association, American College of Cardiology, European Society of Cardiology, European Society of Hypertension, and International Society of Hypertension have all issued similar recent statements urging continuation of the renin-angiotensin-aldosterone
system antagonists in patients, despite theoretical concerns that their use might worsen outcomes in the event of infection with COVID-19.
Anwar Santoso, MD, Ph.D, FAsCC
President of AFC
Ng Wai Kiat, MD, FAsCC
Secretary General of AFC