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COVID-19, hypertension and cardiovascular diseases: Should we change the therapy?

Marijana Tadic1, Cesare Cuspidi2, Giuseppe Mancia3

  • 1University Hospital "Dr. Dragisa Misovic - Dedinje", Department of Cardiology, Belgrade, Serbia.

Pharmacological Research
|May 29, 2020
PubMed

Insights

Patients with hypertension and cardiovascular diseases (CVD) are not independent predictors of severe outcomes in COVID-19. Continued treatment with renin-angiotensin-aldosterone system (RAAS) inhibitors is recommended for these patients.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • The coronavirus disease (COVID-19) pandemic has highlighted the prevalence of comorbidities like arterial hypertension and cardiovascular diseases (CVD) among infected individuals.
  • Questions remain regarding the susceptibility, disease progression, and prognosis of COVID-19 patients with these underlying conditions.
  • Limited data exists on the impact of these comorbidities and their treatments on COVID-19 outcomes.

Purpose of the Study:

  • To review the prevalence of hypertension and CVD in COVID-19 patients.
  • To analyze the influence of these conditions on COVID-19 outcomes.
  • To evaluate the effects of managing hypertension and CVD during the COVID-19 pandemic.

Main Methods:

  • Literature review of existing studies on COVID-19 patients with hypertension and CVD.
  • Analysis of data on disease prevalence, outcomes, and treatment effects.
  • Synthesis of findings regarding the role of the renin-angiotensin-aldosterone system (RAAS) and its inhibitors.

Main Results:

  • Hypertension and CVD were not independent predictors of mortality in COVID-19 patients after adjusting for clinical and demographic factors.
  • Speculation exists regarding the association between RAAS and COVID-19 susceptibility, but withdrawing RAAS inhibitors poses significant risks.
  • Discontinuing RAAS inhibitors could lead to uncontrolled hypertension and organ damage, potentially worsening COVID-19 outcomes.

Conclusions:

  • Patients with hypertension and CVD do not appear to have a worse prognosis for lethal outcomes in COVID-19 when other factors are considered.
  • Continuing RAAS inhibitor therapy is crucial for managing underlying conditions and avoiding complications that could be more detrimental than COVID-19 itself.
  • Further research is needed to clarify the complex interactions between cardiovascular health, COVID-19, and its treatments.

Keywords:
COVID-19Cardiovascular diseaseHypertensionOutcome

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