Medication for high blood pressure may improve COVID-19 survival rates, and reduce the severity of novel coronavirus infection, particularly in patients with hypertension, according to a study. Researchers from the University of East Anglia (UEA) in the UK studied 28,000 patients taking antihypertensives — a class of drugs that are used to treat hypertension or high blood pressure. The study, published in the journal Current Atherosclerosis Reports, found that the risk of severe COVID-19 illness and death was reduced for patients with high blood pressure who were taking Angiotensin-Converting Enzyme inhibitors (ACEi) or Angiotensin Receptor Blockers (ARB). “We know that patients with cardiovascular diseases are at particular risk of severe Covid-19 infection,” said lead researcher Vassilios Vassiliou, from UEA’s Norwich Medical School. “But at the start of the pandemic, there was concern that specific medications for high blood pressure could be linked with worse outcomes for COVID-19 patients,” Vassiliou said. The researchers, including those from Norfolk and Norwich University Hospital, analysed what the impact of these medications is for people with COVID-19. They studied the outcomes for patients taking antihypertensives, looking particularly at what is called ”critical” outcomes such as being admitted to intensive care or being put on a ventilator, and death. The team analysed data from 19 studies related to COVID-19 and ACEi and ARB medications. The researchers noted that their meta-analysis involved more than 28,000 patients and is the largest and most detailed such study to date. They compared data from COVID-19 patients who were taking ACEi or ARB medications with those who were not — focusing on whether they experienced ”critical” events and death. “We found that a third of COVID-19 patients with high blood pressure and a quarter of patients overall were taking an ACEi/ARBs. This is likely due to the increasing risk of infection in patients with co-morbidities such as cardiovascular diseases, hypertension and diabetes,” said Vassiliou. “But the really important thing that we showed was that there is no evidence that these medications might increase the severity of COVID-19 or risk of death,” he said. On the contrary, the researchers found that there was a significantly lower risk of death and critical outcomes, so they might in fact have a protective role — particularly in patients with hypertension. COVID-19 patients with high blood pressure who were taking ACEi/ARB medications were 0.67 times less likely to have a critical or fatal outcome than those not taking these medications, according to the study. “Our research provides substantial evidence to recommend continued use of these medications if the patients were taking them already,” said Vassiliou. “However, we are not able to address whether starting such tablets acutely in patients with Covid-19 might improve their prognosis, as the mechanism of action might be different,” he added.
