- Three separate observational studies analyzed the use of certain blood pressure medicine that some coronavirus patients might be taking and concluded that the drugs aren’t risk factors for COVID-19.
- The drugs the doctors analyzed are angiotensin-converting-enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs), which some people believed might impact the ACE2 protein that the virus binds to.
- The findings are relevant because people suffering from hypertension should continue to take their blood pressure regardless of whether they’re infected with the new virus or not.
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UPDATE June 4th, 2020: An investigation from The Guardian raised concerns about the validity of the Surgisphere data used in one of the studies, prompting an independent review from co-authors of the study, as well as an expression of concern from the New England Journal of Medicine.
UPDATE June 5th, 2020: The NEJM retracted the study authored by Mehra and others after the co-authors were not able to verify the Surgisphere dataset. The original post follows below.
Hypertension and any other sort of cardiovascular disease are all factors for people who are infected with the novel coronavirus. The older the patients are, the greater the risk of developing potentially life-threatening COVID-19 complications. But researches keep delivering good news that will hopefully improve the outcome of severe coronavirus cases and increase the chances of survival. Earlier this week, we heard that remdesivir will become the standard treatment for COVID-19, as the drug can speed up recovery times. An extensive study found no conclusive proof that the drug can reduce the number of fatalities though, so people might still die of COVID-19 complications. But vaccine research is advancing at lightning speed and a vaccine might be ready for emergency use as soon as this fall. The general population might even get one in January if everything works out, at least in some countries.
Getting back to high blood pressure, a very common condition, researchers from three separate teams have now delivered the same good news. Certain hypertension drugs that may interact with the ACE2 cell receptors that the SARS-CoV-2 virus binds to are not a risk factor for COVID-19 patients. That means physicians can continue to prescribe the much-needed medicines that control high blood pressure to coronavirus patients without worrying it may pose a risk, as had previously been rumored.
There separate observational studies looked at different cohorts of COVID-19 patients and the effects of their blood pressure drugs on the outcome of the disease. Observational studies aren’t as strong as experimental ones, such as the recent remdesivir trial where the effects of a drug are observed in comparison with a placebo group. They’re still relevant, however. “We find it reassuring that three studies in different populations and with different designs arrive at the consistent message,” a NEJM editorial said.
While there are plenty of therapies to control hypertension, the researchers looked at the angiotensin-converting-enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs), Agence France-Presse reported. Some of these drugs are also given to patients with diabetes to protect their kidneys. Diabetics often also have high blood pressure.
ACE inhibitors include medicines that end in “-pril” like ramipril and lisinopril, while ARBs include meds that have “-sartan” at the end, such as valsartan and losartan. Interestingly, losartan was one of the drugs that we recently heard mentioned as a potential remedy for COVID-19 patients.
AFP notes there has been concern from animal studies that said these drugs may increase the body’s levels of ACE2, which is the receptor the novel coronavirus connects to in order to enter lung cells and start replicating. The three separate studies were published in the New England Journal of Medicine (NEJM) on Friday.
“We saw no difference in the likelihood of a positive test with ACE inhibitors, with angiotensin receptor blockers,” NYU Grossman School of Medicine Harmony Reynolds told AFP. She led a study on 12,600 people and said her findings were relieving because she had a number of patients questioning her on whether they should stop their blood pressure medicine after reading the news. “I’m very happy to be able to tell patients that they should continue their blood pressure medications,” she said.
The doctor said the findings are significant, especially because lockdown life may have some adverse effects on cardiac patients, including increased blood pressure “maybe from stress or less exercise or eating differently.”
A separate study led by Mandeep Mehra and Brigham and Women’s Hospital found that the ACE and ARB drugs may be potentially tied to a lower risk of death from COVID-19. But these findings were not corroborated by the others and more research might be required. This study had 8,910 patients from 169 hospitals.
The third study led by Giuseppe Mancia looked at 6,272 COVID-19 patients in Lombardy, Italy, and compared them to a control group of 30,759 people. “In this large, population-based study, the use of ACE inhibitors and ARBs was more frequent among patients with COVID-19 than among controls because of their higher prevalence of cardiovascular disease,” the study reads. “However, there was no evidence that ACE inhibitors or ARBs affected the risk of COVID-19.”
A separate observational study that looked at the evolution of some 5,700 coronavirus patients found that of the patients who had died following coronavirus complications, those on medication for hypertension were less likely to have received ventilation or ICU care compared to people without high blood pressure.