International Journal of Pharmacology1811-77751812-5700Asian Network for Scientific Information10.3923/ijp.2021.435.441A.S. MuradHussam S. Al-KayyalSuleiman A. AlkaabiTurky 72021177Background and Objective: The cardiovascular diseases are the most frequent comorbidities of Covid-19 infection. The severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) employs the angiotensin converting enzyme 2 (ACE2) receptor to invade cells. Angiotensin receptor blockers (ARBs) do not directly interact with ACE2 receptor, but they could affect course of Covid-19 infection because they increase expression of ACE2 and this could offer more binding sites for the virus. However, this could support cardio-pulmonary protective effects of the ACE2/Ang-(1-7)/Mas axis. Also, sensitivity of an individual to COVID-19 infection might be affected by ACE2 polymorphism. To my knowledge, there are no clinical data to explain whether use of ARBs in COVID-19 patients with cardiovascular diseases is the same for all members or that some ARB members are preferred than others? This review tries to shed light on this issue. Materials and Methods: Wide literature search using many key words related to ARBs and COVID-19. Results: The newest ARBs (Olmesartan medoxomil and Azilsartan medoxomil) block the angiotensin II receptor 1 (AT1R) with inverse agonist activities, have no antagonistic effects on AT2R, upregulate ACE2 and stimulate ACE2/Ang-(1-7)/Mass receptor pathway. They are poor activators of peroxisome proliferator-activated receptor-γ (PPARγ) whose activation is not needed for their metabolic benefits. In addition, Olmesartan medoxomil inhibits ACE and decreases the plasma level of angiotensin II. Conclusion: In spite of their favorable pharmacological profiles, there is no enough evidence to support choice of the newest ARBs rather than the old ones for treatment of cardiovascular morbidities in COVID-19 patients.]]>Warner, F.J., R.A. Lew, A.I. Smith, D.W. Lambert, N.M. Hooper and A.J. Turner,20052803935339362Guan, W., Z. Ni, Y. Hu, W. Liang and C. Ou et al.,202038217081720Sparks, M.A., S.D. Crowley, S.B. Gurley, M. Mirotsou and T.M. Coffman,2011412011228Santos, R.A.S., W.O. Sampaio, A.C. Alzamora, D. Motta-Santos, N. Alenina, M. Bader and M.J. Campagnole-Santos,201898505553Stawiski, E.W., D. Diwanji, K. Suryamohan, R. Gupta and F.A. Fellouse et al.,20202020Wang, W., V.B. Patel, N. Parajuli, D. Fan and R. Basu et al.,201492847858Patel, V.B., J.C. Zhong, M.B. Grant and G.Y. Oudit,201611813131326Lew, R.A., F.J. Warner, I. Hanchapola, M.A. Yarski, J. Manohar, L.M. Burrell and A.I. Smith,200893685693Pinto, B.G.G., A.E.R. Oliveira, Y. Singh, L. Jimenez and A.N.A. Gonçalves et al.,2020222556563Li, M.Y., L. Li, Y. Zhang and X.S. Wang,20202020Gheblawi, M., K. Wang, A. Viveiros, Q. Nguyen and J.C. Zhong,202012614561474Ciaglia, E., C. Vecchione and A.A. Puca,20202020Fang, L., G. Karakiulakis and M. Roth,20202020Walls, A.C., Y.J. Park, M.A. Tortorici, A. Wall, A.T. McGuire and D. Veesler,20202020Monteil, V., H. Kwon, P. Prado, A. Hagelkrüys and R.A. Wimmer et al.,2020181905913Gibson, W.T., D.M. Evans, J. An and S.J. Jones,20202020Liu, D., Y. Chen, P. Zhang, J. Zhong and L. Jin et al.,20162016Burrell, L.M., S.B. Harrap, E. Velkoska and S.K. Patel,20131246576Devaux, C.A., J.M. Rolain and D. Raoult,202053425435Li, J., X. Wang, J. Chen, H. Zhang and A. Deng,20202020Wan Y., Shang J., Graham R., Baric R.S. and Li F.,202094e00127e00127Alifano, M., P. Alifano, P. Forgez and A. Iannelli,20201743033Guo, J., Z. Huang, L. Lin and J. Lv,20202020Bozkurt, B., R. Kovacs and B. Harrington,20202020Saavedra, J.M.,201636259279Miura, S.I., M. Fujino and K. Saku,20051115121Koike, H., T. Sada and M. Mizuno,2001In vitro and in vivo pharmacology of olmesartan medoxomil, an angiotensin II type AT1 receptor antagonist.]]>19S3S14Sakata, Y., K. Nochioka, M. Miura, T. Takada and S. Tadaki et al.,2013623136Qin, Y., N. Yasuda, H. Akazawa, K. Ito and Y. Kudo et al.,20091 receptor blockers against stretch-induced AT1 receptor activation.]]>32875883Kellici, T.F., D. Ntountaniotis, G. Liapakis, A.G. Tzakos and T. Mavromoustakos,20191250625078Ishiyama, Y., P.E. Gallagher, D.B. Averill, E.A. Tallant, K.B. Brosnihan and C.M. Ferrario,200443970976Ichikawa, S. and Y. Takayama,200124641646Agata, J., N. Ura, H. Yoshida, Y. Shinshi and H. Sasaki et al.,200629865874Tsutamoto, T., K. Nishiyama, M. Yamaji, C. Kawahara, M. Fujii, T. Yamamoto and M. Horie,201033118122Liu, Y., Y. Yang, C. Zhang, F. Huang and F. Wang et al.,202063364374Ohshima, K., M. Mogi, H. Nakaoka, J. Iwanami and L.J. Min et al.,20142014Furuhashi, M., N. Moniwa, T. Mita, T. Fuseya and S. Ishimura et al.,2015281521Tada, Y., K. Yagi, M. Uno, N. Matsushita and Y. Kanematsu et al.,20152414871492Perry, C.M.,201232621639Miura, S.I., A. Okabe, Y. Matsuo, S.S. Karnik and K. Saku,201336134139Angeloni, E.,20162016Carroll, M.A., Y. Kang, P.N. Chander and C.T. Stier,201528664671Pradhan, A., A. Tiwari and R. Sethi,20192019Stockbridge, N.,201145567567White, W.B., R.H. Cuadra, E. Lloyd, G.L. Bakris and S. Kupfer,201634788797Kakio, Y., H.A. Uchida, R. Umebayashi, H. Takeuchi, Y. Okuyama, Y. Hanayama and J. Wada,2017225967Iwanami, J., M. Mogi, K. Tsukuda, X.L. Wang and H. Nakaoka et al.,201437616620Schrier, R.W.,20102010Sezai, A., S. Osaka, H. Yaoita, M. Arimoto, H. Hata, M. Shiono and H. Sakino,201622161167