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Use of common blood pressure medications: angiotensin-converting enzyme inhibitors (ACEI) or angiotensin-blocking (ARB) drugs does not affect susceptibility to, or severity of, COVID-19: JAMA Network

2020-06-25

Coronavirus studies by Engin Akyurt via pixabay.com

A Journal of the American Medical Association (JAMA) Network article published June 19 indicates that use of common antihypertensive medications ACEI/ARB does not affect outcomes related to COVID-19.  The retrospective cohort study using data from Danish national administrative registries covering February 22 to May 4 and looking at 4480 patients found 895 who used these drugs to control high blood pressure.  The study concluded:

Conclusions and Relevance  Prior use of ACEI/ARBs was not significantly associated with COVID-19 diagnosis among patients with hypertension or with mortality or severe disease among patients diagnosed as having COVID-19. These findings do not support discontinuation of ACEI/ARB medications that are clinically indicated in the context of the COVID-19 pandemic.

This study is reassuring because there had been concerns related to the mechanism of infection, namely that the virus SARS-COV-2 uses cell surface ACE-2 receptors to gain access and infect epithelial cells in the respiratory tract.  Apparently, taking drugs that inhibit ACE or block the angiotensin receptor do not enhance the virus’ ability to infect or kill cells.  Therefore, it is not necessary for patients taking these drugs to control their blood pressure to discontinue them for fear of enhanced infection.  This is good because high blood pressure in general as well as advanced age (and higher rates of hypertension) has been found to be associated with higher mortality rates from COVID-19.

The findings from this study confirm prior research that found no association of taking the drugs with increased mortality or infection rates.

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