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Renin-angiotensin system antagonists are associated with lower mortality in hypertensive patients with COVID-19

Michael Megaly1, Mattew Glogoza2

  • 1Interventional cardiology fellow, Minneapolis Heart Institure, Abbott Northwestern Hospital, USA.

Scottish Medical Journal
|August 19, 2020
PubMed

Insights

Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs) did not significantly alter mortality in COVID-19 patients. However, hypertensive patients on ACEIs/ARBs showed reduced mortality, warranting further investigation.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pharmacology

Background:

  • The role of renin-angiotensin-aldosterone system inhibitors, including ACEIs and ARBs, in COVID-19 patients has been a subject of clinical debate.
  • This meta-analysis aimed to synthesize existing evidence on the association between ACEI/ARB use and clinical outcomes in COVID-19.

Discussion:

  • The pooled analysis of four observational studies (3,267 patients) indicated no significant difference in all-cause mortality between COVID-19 patients using ACEIs/ARBs and those not.
  • A subgroup analysis focused on hypertensive patients revealed a statistically significant reduction in mortality risk for those treated with ACEIs/ARBs.

Key Insights:

  • ACEI/ARB use in the general COVID-19 population is not associated with increased mortality.
  • Hypertensive COVID-19 patients receiving ACEIs/ARBs may experience a survival benefit.

Outlook:

  • Further research is necessary to confirm the protective effect of ACEIs/ARBs in hypertensive COVID-19 patients.
  • Investigating the precise mechanisms behind this potential benefit is crucial for clinical practice guidelines.

Keywords:
Angiotensin II receptor blockersAngiotensin-converting enzyme inhibitorsCOVID-19coronavirushypertension

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