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Antihypertensive medications and COVID-19 diagnosis and mortality: Population-based case-control analysis in the

Emma Rezel-Potts1,2, Abdel Douiri1,2,3, Phil J Chowienczyk4

  • 1King's College London, School of Population Health and Environmental Sciences, London, UK.

British Journal of Clinical Pharmacology
|April 28, 2021
PubMed

Insights

Antihypertensive medications like ACE inhibitors and ARBs were linked to lower COVID-19 diagnosis odds. Most antihypertensive therapies showed no increased risk for COVID-19 diagnosis or mortality.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Antihypertensive drugs' role in COVID-19 susceptibility and severity is debated.
  • Previous estimates may be affected by bias, particularly healthcare-seeking behavior.
  • Understanding these associations is crucial for patient management during the pandemic.

Purpose of the Study:

  • To investigate the association between specific antihypertensive medications and COVID-19 diagnosis.
  • To evaluate the relationship between antihypertensive drug classes and COVID-19 related mortality.
  • To account for potential confounding factors, including healthcare-seeking behavior.

Main Methods:

  • A population-based case-control study using UK Clinical Practice Research Datalink data.
  • Inclusion of 16,866 COVID-19 cases and 70,137 matched controls.
  • Analysis of exposures including ACE inhibitors (ACEIs), ARBs, beta-blockers, calcium-channel blockers, thiazide diuretics, and other antihypertensives, adjusted for covariates and consultation frequency.

Main Results:

  • ACE inhibitors and ARBs were associated with significantly lower odds of COVID-19 diagnosis.
  • Calcium-channel blockers and thiazide diuretics also showed reduced odds of COVID-19 diagnosis.
  • Beta-blockers showed an initial increased odds of diagnosis, which was attenuated after adjusting for consultation frequency. No antihypertensive class was associated with increased COVID-19 mortality.

Conclusions:

  • Antihypertensive therapy, particularly ACE inhibitors and ARBs, is not associated with an increased risk of COVID-19 diagnosis or mortality.
  • Most antihypertensive drug classes demonstrated a negative association with COVID-19 diagnosis.
  • Findings suggest potential protective effects or that certain drug classes are prescribed to individuals with lower COVID-19 risk.
Abstract

Keywords:
COVID-19SARS-CoV-2angiotensin converting enzyme inhibitorsangiotensin receptor blockersantihypertensive treatmentclinical practice research datalinkrenin-angiotensin-aldosterone system inhibitors

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