Immunomodulator Activity of ACE Inhibitors and Angiotensin Receptor Blockers in Hypertensive Patients

There is a notable association between the autonomic and immune systems in the development of hypertension, contributing to cardiovascular pathology and organ damage. Angiotensin-converting enzyme (ACE) inhibitors, widely used antihypertensive agents, prevent the conversion of angiotensin I to angiotensin II, thereby reducing blood pressure and modulating immune responses by altering bradykinin and substance P, both involved in inflammation. ACE inhibitors also enhance ACE2 expression, which may increase susceptibility to pathogens like SARS-CoV-2. Angiotensin receptor blockers (ARBs) work by blocking the angiotensin II type 1 receptor (AT1R), reducing inflammation by downregulating proinflammatory pathways. Recent studies suggest both ACE inhibitors and ARBs have immunomodulatory properties that could benefit patients with autoimmune diseases. These medications potentially reduce cytokine secretion and adhesion molecule expression, making them promising for treating conditions with inflammatory responses, such as autoimmune disorders and metabolic syndrome.