On the "All you need is lab" program on Tuesday, July 21, the Dra. María Paz Ocaranza, principal investigator of our CENDHY associates, referred to the relationship between high blood pressure and coronavirus, in light of statistics: "those patients who respond most severely to SARS-CoV-2 infection, the highest proportion have hypertension, therefore there is a fairly direct relationship in terms of coronavirus and how hypertensive patients respond".

The titular researcher of CENDHY was invited to the USACH Radio program 94.5 FM "All you need is lab", led by journalist Iveliz Martel and whose editor is the scientific journalist Nadia Politis, to discuss the fundamentals of the relationship between hypertension and COVID-19, as an expert with extensive experience in preclinical studies in hypertension and cardiovascular damage.

"Hypertension is a chronic disease that has a high prevalence in Chile, 27.6%, so it's a fairly common disease in the population", established the researcher of the Division of Cardiovascular Diseases of the School of Medicine of the Pontifical Catholic University of Chile (PUC), alling to data from the latest National Health Survey 2016/2017. She explained that "hypertension is related to an increased proportion of the immune response and therefore a significant number of hypertensive patients have an inflammatory cause".

When consulted by driver Iveliz Martel about the risk factors for hypertension and the effects it has on the body, doctor noted that "from a physiological point of view, hypertension has several mechanisms and one of the most fundamental is the renin-angiotensin system, focusing on most drugs today available to treat hypertension". Current treatment for high blood pressure consists of, among other elements, permanent use of antihypertensive drugs, for the most part, aim to inhibit the classic pathway of the renin-angiotensin system and are part of the base therapy with which the treatment of hypertensive patients is initiated, as the researcher pointed out.

On the connection between hypertension and coronavirus, the Dra. Ocaranza explained that "the point of relationship is precisely the renin-angiotensin system, physiologically on a scale between a "bad" or spelling route and a positive route, and it is in this positive pathway that the ECA-2 receptor is involved that allows the coronavirus to enter the body and that produces COVID-19". The researcher participated in a special article of the Chilean Journal of Cardiology in which, in conjunction with researchers at the Advanced Center for Chronic Diseases (ACCDiS ), PUC School of Medicine and the University of Texas Southwestern Medical Center, described the relationship between the positive or "canonical" pathway of the renin-angiotensin system and the infection Coronavirus.

Specifically, as the researcher illustrated: "this is a concept of key and lock, in which the virus is the key, and the lock is this protein ECA-2". Coronavirus enters the body through the ECA-2 receptor and begins to replicate into infected cells, i.e., produces copies of itself and expands through the body, infecting other organs; and that's how the virus self-holds. "The ECA-2 enzyme is abundant in some tissues and that is why they will be more damaged as a result of the action of this virus". Adding that "mainly this protein is present in the upper airway and in the lungs fundamentally, But it's also in the heart, in the blood vessels, in the liver and intestine, and that's why you have some pictures of diarrhea in patients".

Driver Iveliz Martel asked the specialist about the abundance of ECA-2 in people with high blood pressure, to which he replied that "what has been seen is that hypertensive patients have the pathway where ECA-2 is altered and what happens is that the spelling pathway is activated, which favors the pathogenicity of the virus".

The journalist then consulted on the recommendations of hypertensive and chronically ill patients about continuing their drug treatments, to which Dr.. Ocaranza clarified on the basis of scientific evidence that "the recommendation is to maintain the therapy proposed by his treating physician, under no circumstances stop taking your medications. The big controversy arose from reported data on antihypertensive drugs that block the harmful pathway, which was seen to increase the proportion of the ECA-2 protein". However, clarified that "but what happens is that in addition to producing this increase, they also generate an increase in the production of molecules with a positive and protective effect, that counteract the action of the virus and decrease its pathogenicity, therefore from that point of view it is even more advisable to maintain therapy".

CENDHY's lead researcher was consulted on the cardiovascular consequences of COVID-19 and symptomatology other than respiratory, following hypotheses that propose that this is a virus that affects blood vessels, to which he replied that "this ECA-2 protein is importantly present in the heart and has been seen in those who are infected with this virus have tachycardia and may also have pictures of hypertension because it causes the contraction of blood vessels and thus an increase in blood pressure".

To conclude, and in relation to symptoms such as headaches and headaches, the Dra. Ocaranza explained that "the receptor is also present at the central nervous system level, and we could say then that there is actually multi-organ damage" and reiterated that "that's why it's important to be emphatic in that patients, either with hypertension, diabetes or basic cardiovascular disease, which are the leading cause of death worldwide, they should not give up their therapy".