A new study, published in the journal Circulation Research, has defended the use of commonly prescribed high blood pressure drugs called ACE (angiotensin-converting enzyme) inhibitors and ARBs (angiotensin II receptor blockers) in patients with COVID-19, the disease caused by the novel coronavirus.
As the ongoing coronavirus pandemic continues to grow, researchers are leaving no stone unturned to find a cure, especially for patients with underlying medical conditions, including hypertension.
Among more than 170,000 deaths caused by the new coronavirus, the vast majority of them include older patients, with one major underlying risk factor being hypertension or cardiovascular obstruction.
Therefore, it is imperative to control high blood pressure appropriately while patients are is suffering from COVID-19.
High blood pressure drugs, such as ACE inhibitors and ARBs, have been extensively used in managing hypertension.
However, it has been found that the ACE-2 receptor is one of the entry points for the new coronavirus, providing the virus to enter the cells and increasing the complexity of COVID-19; thus, creating controversy about the use of ACE inhibitors and ARBs in COVID-19 patients.
At the same time, it has been found that there is no strong evidence thatACE-2 is blocked by these antihypertensive agents.
A Chinese study found that high blood pressure increased the risk of more severe illness, with a higher mortality rate. It also found that COVID-19 patients who were on ACE inhibitors or ARBs were less likely to develop a severe illness or die.
However, the researchers pointed out several limitations of the study. First, it was an observational and retrospective study, meaning it cannot assign a causative role to any observed association. Second, there were unknown confounding factors, which could have affected the outcome.
In spite of these limitations, there are possible reasons why these high blood pressure drugs might not cause any harm or could benefit COVID-19 patients.
Experts advise continuing ACE inhibitors or ARBs unless otherwise indicated.
The withdrawal or discontinuation of these antihypertensive drugs may actually cause more harm than good. Earlier this month, the American Heart Association (AHA) issued new guidance advising patients to stay on their high blood pressure medications because uncontrolled hypertension was associated with an increased risk of developing serious coronavirus complications.
