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Hypertension and its management in COVID-19 patients: The assorted view

Gaber El-Saber Batiha1, Abdulrahim Gari2,3, Norhan Elshony1

  • 1Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, 22511, AlBeheira, Egypt.

International Journal of Cardiology. Cardiovascular Risk and Prevention
|November 22, 2021
PubMed

Insights

Hypertension independently increases COVID-19 severity by affecting endothelial function. Medications like ACE inhibitors (ACEIs) and ARBs may benefit hypertensive patients with COVID-19.

Area of Science:

  • Cardiovascular Medicine
  • Infectious Diseases
  • Pharmacology

Background:

  • Coronavirus disease 2019 (COVID-19) disproportionately affects patients with cardiovascular diseases (CVD), particularly hypertension.
  • SARS-CoV-2 infection disrupts the renin-angiotensin-aldosterone system (RAAS) via ACE2 downregulation, increasing harmful Ang II and decreasing protective Ang-(1-7).
  • Hypertension management commonly involves angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs).

Purpose of the Study:

  • To investigate the association between hypertension and COVID-19 severity.
  • To explore the role of ARBs and ACEIs in hypertensive COVID-19 patients.

Main Methods:

  • Comprehensive literature search conducted across major scientific databases (Web of Science, Scopus, PubMed, Google Scholar, ResearchGate).
  • Search covered articles and preprints from late December 2019 to early January 2021.

Main Results:

  • Hypertension identified as an independent risk factor for severe COVID-19.
  • Both ACEIs and ARBs demonstrated beneficial effects in managing hypertensive individuals.

Conclusions:

  • Hypertension exacerbates COVID-19 severity due to endothelial dysfunction and coagulopathy.
  • COVID-19 may worsen hypertensive complications by downregulating ACE2.
  • ACEIs or ARBs show potential as beneficial treatments for hypertensive patients with COVID-19.
Abstract

Keywords:
ACE2Coronavirus disease 2019HypertensionSARS-CoV-2

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