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Pharmacotherapy for hypertensive urgency and emergency in COVID-19 patients

Fabio Angeli1, Paolo Verdecchia2, Gianpaolo Reboldi3

  • 1Department of Medicine and Surgery, University of Insubria - Varese and Department of Medicine and Cardiopulmonary Rehabilitation, Maugeri Care and Research Institute, IRCCS, Tradat, Italy.

Expert Opinion on Pharmacotherapy
|October 12, 2021
PubMed

Insights

Elevated blood pressure in COVID-19 patients is linked to worse outcomes. Prompt treatment for hypertensive emergencies and urgencies is crucial for better patient prognosis.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Hypertension is prevalent in hospitalized coronavirus disease 2019 (COVID-19) patients.
  • Elevated blood pressure during hospitalization correlates with increased mortality, ICU admission, and heart failure.
  • The full impact of high blood pressure during acute COVID-19 is not well-defined.

Purpose of the Study:

  • To review pharmacotherapy for acute blood pressure elevations in COVID-19 patients.
  • To define the burden of elevated blood pressure in acute COVID-19.
  • To outline treatment strategies for hypertensive urgency and emergency in COVID-19.

Main Methods:

  • Literature review of pharmacotherapy for acute blood pressure elevation in COVID-19.
  • Analysis of evidence on treating hypertensive urgency and emergency.
  • Synthesis of treatment goals and drug classes for elevated blood pressure in COVID-19.

Main Results:

  • Acute blood pressure elevations and instability are associated with organ damage and adverse outcomes in COVID-19.
  • Hypertensive emergencies necessitate immediate blood pressure reduction via intravenous therapy.
  • Hypertensive urgencies typically require oral treatment.

Conclusions:

  • Unstable blood pressure in COVID-19 patients indicates potential organ damage and poorer prognosis.
  • Intravenous medications are key for hypertensive emergencies, while oral agents suffice for urgencies.
  • Diuretics, beta-blockers, RAAS inhibitors, and calcium channel blockers are beneficial for managing elevated blood pressure in COVID-19.
Abstract

Keywords:
COVID-19SARS-CoV-2blood pressureblood pressure lowering drugshypertensionhypertensive emergencieshypertensive urgenciesoutcometreatment

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