Hypertension is associated with increased risk of death from COVID-19

Patients with hypertension have a twofold increased risk of dying from the coronavirus COVID-19, compared to patients without hypertension, according to a new study published in. European Heart Journal today.

Furthermore, in this study, patient high blood pressure Those who did not take the drug to control their condition were at greater risk of dying from COVID-19.

Chinese and Irish researchers analyzed data from 2866 COVID-19 patients admitted to the Huangjinshan Hospital in Wuhan, China, from February 5, 2020 to March 15, 2020. The hospital opened only on February 5 for the treatment of patients with coronavirus. Of these patients, 29.5% (850) High blood pressure (High blood pressure).

Researchers led by Professors Fei Li and Ling Tao at Xijing Hospital found that 34 out of 850 (4%) patients with coronavirus hypertension died compared to 22 out of 2027 (1.1%) without hypertension. I discovered that I did -2.12 times Increased risk After adjusting for factors that may affect your results, such as age, gender, and other medical conditions.

Among hypertensive patients who were not taking drugs in this condition, 11 of 140 (7.9%) died of coronavirus, compared with 23 of 710 (3.2%) of those who were taking the drug. Had a 2.17-fold increase in risk after adjusting for confounding. Factor.

In a meta-analysis, researchers combine data from Huo Shen Wan patients with data from about 2,300 patients from three other studies to show that patients treated with drugs that target renin-angiotensin- Mortality was investigated in the aldosterone system (RAAS). These drugs include angiotensin converting enzyme (ACE) inhibitors or Angiotensin receptor blocker (ARB). Other non-RAAS inhibitors used to treat hypertension include beta blockers, calcium channel blockers (CCBs), or diuretics.

They found that 183 patients treated with RAAS inhibitors had a lower risk of death than 527 patients treated with other drugs. However, because the number of patients in this analysis is small, it may be due to chance, so the researchers say this result needs to be treated with caution.

“It is important to understand that hypertensive patients are at increased risk of dying from COVID-19. During this pandemic, they need to take care of themselves. Coronavirus.

“In addition, there were 140 patients hospitalized with COVID-19 who discontinued antihypertensive treatment for various reasons, which was found to be associated with an increased risk of death from coronavirus.

“In contrast to our first hypothesis, RAAS inhibitors such as ACE inhibitors and angiotensin receptor blockers are not associated with an increased risk of death from COVID-19 and are actually protective.” It was possible, so patients should not discontinue or change their regular antihypertensive therapy unless directed by their doctor.”

Professor Lin Tao said: “Soon after starting treatment for COVID-19 patients in Wuhan in early February, we realized that nearly half of the dead patients had hypertension. COVID-19 symptoms. At the same time, some researchers said that RAAS inhibitor Coronavirus It invades cells and makes people vulnerable to disease.

“I was very surprised that these results did not support the original hypothesis. In fact, the results were in the opposite direction, tending to favor ACE inhibitors and ARB. Clinical evidence More important than ever. “

Because this was a study that examined data from hospital observations, it was too early for the researchers to make clinical recommendations based on these results and was randomized. Clinical trial Particular attention should be paid to the role played by RAAS inhibitors.

“These data should be interpreted carefully, but they support recommendations to the European Heart Association that patients should not stop or change their usual antihypertensive treatment,” Professor Tao said. Said.

Since there are currently few COVID-19 diagnoses in China, EHJ co-authors J. William McEvoy and Patrick Serruys will conduct a randomized clinical trial at the National University of Ireland Galway.

“I have three questions left and hope our clinical trials in Ireland will answer the first two,” Serruys said. What Drugs Should We Give to Hypertensive COVID-19 Patients? Can RAAS inhibitors or non-RAAS inhibitors—and these drug therapies reduce the risk of death in these patients?

“For the last question, see a recent population-based study. New England Medical Journal It suggests that antihypertensive drugs such as ACE inhibitors and ARBs are not associated with an increased risk of positive COVID-19 tests. “

Since this is a retrospective observational study, a causal relationship between RAAS inhibitors and COVID-19 mortality cannot be shown. Other restrictions include the inability to include all relevant confounders. Some data, such as the electrocardiogram (ECG), was not recorded in detail. Also, the effects of antihypertensive drugs can only be assessed in the short term, and prospective studies are needed to confirm their long-term effects.

The editorial on this paper is EHJ at the same time.