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Hypertension, renin-angiotensin-aldosterone-system-blocking agents, and COVID-19
Si-Hyuck Kang1,2,3, Dong-Hoon Lee1, Kyung-Do Han4
1Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Clinical Hypertension
|June 1, 2021
Summary
Hypertension increases COVID-19 severity, but renin-angiotensin-aldosterone-system (RAAS)-blocking agents like ACE inhibitors (ACEI) and ARBs do not raise adverse outcomes. Continue these vital medications for hypertension patients during COVID-19.
Area of Science:
- Cardiology
- Infectious Diseases
- Pharmacology
Background:
- Concerns existed regarding renin-angiotensin-aldosterone-system (RAAS)-blocking agents safety during the COVID-19 pandemic.
- This study investigated hypertension and RAAS-blocking agent use (ACEI/ARB) impact on COVID-19 clinical severity.
Purpose of the Study:
- To evaluate the association between hypertension and COVID-19 clinical severity.
- To assess the safety of ACEI/ARB use in hypertensive patients with COVID-19.
Main Methods:
- A cohort of 3,788 COVID-19 patients (≥30 years) from Korea was analyzed.
- Severe clinical events (ICU admission, ventilation, death) were the primary outcome.
Main Results:
- Hypertension was linked to significantly higher severe COVID-19 outcomes (aOR, 1.67; 95% CI, 1.04-2.69).
- Among treated hypertensive patients, ACEI/ARB use (74.9%) showed a non-significant trend towards lower severe outcomes (aOR, 0.68; 95% CI, 0.41-1.15).
Conclusions:
- Hypertension is a significant risk factor for worse COVID-19 outcomes.
- RAAS-blocking agents (ACEI/ARB) were not associated with increased adverse COVID-19 outcomes, supporting their continued use.
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