Related Experiment Video
Updated: Jun 28, 2025
Author Spotlight: Exploring Huotan Jiedu Tongluo Decoction as an Antihypertensive Drug
Published on: May 17, 2024
Impact of prior antihypertensive treatment on COVID-19 outcomes, by active ingredient
Rosa María García-Álvarez1,2, Maruxa Zapata-Cachafeiro3,4,5, Irene Visos-Varela2
1Service of Preventive Medicine and Public Health, Clinic Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
Insights
Chronic treatment with angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs) significantly reduced the risk of severe COVID-19 outcomes, including hospitalization and mortality. Specific medications like enalapril and candesartan showed notable protective effects.
Area of Science:
- Cardiovascular Pharmacology
- Infectious Disease Epidemiology
- Real-World Evidence Studies
Background:
- Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs) are widely prescribed for cardiovascular conditions.
- The potential impact of these medications on COVID-19 severity has been a subject of significant research interest.
- Understanding drug effects in real-world settings is crucial for patient management.
Purpose of the Study:
- To evaluate the association between prior ACEI/ARB use and COVID-19 outcomes.
- To assess the impact of specific ACEI and ARB agents on COVID-19 hospitalization, mortality, progression, and susceptibility.
- To analyze real-world data for evidence-based clinical recommendations.
Main Methods:
- A population-based case-control study was conducted in Galicia, Spain.
- Data were extracted from comprehensive medical, administrative, and clinical databases.
- Outcomes assessed included hospitalization, mortality, disease progression, and susceptibility to SARS-CoV-2, with adjusted odds ratios calculated.
Main Results:
- Both ACEIs and ARBs were associated with reduced risk of hospitalization, mortality, and susceptibility to COVID-19.
- Specifically, enalapril use correlated with lower risks of hospitalization, mortality, and susceptibility.
- Candesartan use was linked to decreased risks of hospitalization, mortality, and disease progression.
Conclusions:
- This large-scale real-world study indicates that ACEIs and ARBs are associated with a significant reduction in severe COVID-19 outcomes.
- Enalapril and candesartan, in particular, demonstrated a considerable protective effect against severe COVID-19.
- Findings support the continued use of these medications in patients with or at risk for COVID-19.
Objectives:
To assess the impact of prior chronic treatment with angiotensin-converting enzyme inhibitors (ACEIs)/ angiotensin-receptor blockers (ARBs), both as a group and by active ingredient, on severity (risk of hospitalization and mortality), progression of and susceptibility to COVID-19.
Methods:
We conducted a multiple population-based case-control study in Galicia (north-west Spain). The study data were sourced from medical, administrative and clinical databases. We assessed: (1) risk of hospitalization, by selecting all patients hospitalized due to COVID-19 with PCR + as cases, and a random sample of subjects without a PCR + as controls; (2) COVID-19 mortality risk; (3) risk of disease progression; and (4) susceptibility to SARS-CoV-2, considering all patients with PCR + as cases, and the same subjects used in the previous model as controls. Adjusted odds ratios (aORs) were calculated.
Results:
ACEIs and ARBs were shown to decrease the risk of hospitalization (aOR = 0.78 [95%CI 0.69-0.89] and aOR = 0.80 [95%CI 0.72-0.90] respectively), risk of mortality (aOR = 0.71 [95%CI 0.52-0.98] and aOR = 0.69 [95%CI 0.52-0.91] respectively), and susceptibility to the virus (aOR = 0.88 [95%CI 0.82-0.94] and aOR = 0.92 [95%CI 0.86-0.97] respectively). By active ingredient: use of enalapril was associated with a significantly lower risk of hospitalization (aOR = 0.72 [95%CI 0.61-0.85]), mortality (aOR = 0.59 [95%CI 0.38-0.92]) and susceptibility to COVID-19 (aOR = 0.86 [95%CI 0.79-0.94]); and use of candesartan was associated with a decreased risk of hospitalization (aOR = 0.76 [95%CI 0.60-0.95]), mortality (aOR = 0.36 [95%CI 0.17-0.75]) and disease progression (aOR = 0.73 [95%CI 0.56-0.95]).
Conclusion:
This large-scale real-world data study suggest that enalapril and candesartan are associated with a considerable reduction in risk of severe COVID19 outcomes.
Related Concept Videos
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
01:25Antihypertensive Drugs: Direct Renin Inhibitors
01:30Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors
01:17Antihypertensive Drugs: Action of β1 Blockers
01:28Antihypertensive Drugs: Types of β-Blockers
01:30Antihypertensive Drugs: Angiotensin II Receptor Blockers