Blood pressure meds could improve survival in Covid-19 patients

  • Initially, there were concerns that some blood pressure medications were harmful to Covid-19 sufferers
  • Researchers found that these medications actually lowered the risk of death and critical outcomes 
  • They recommend continued use of these medications if the patients are taking them already

In the largest such study yet, researchers have found that two classes of common blood pressure medications seem tied to better survival against Covid-19.

The UK findings should allay any worry that the two types of mediations – angiotensin-converting enzyme inhibitors (ACE inhibitors) or angiotensin receptor blockers (ARBs) – might actually harm Covid-19 patients.

"We know that patients with cardiovascular diseases are at particular risk of severe Covid-19 infection," noted lead researcher Dr Vassilios Vassiliou. "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," he said.

Instead, the researchers found that the drugs weren't harmful but rather lowered the risk of death and critical outcomes by about one-third.

Looking at 'critical' outcomes

"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," said Vassiliou, of the Norwich Medical School at the University of East Anglia, in the United Kingdom.

"Our research provides substantial evidence to recommend continued use of these medications if the patients were taking them already," he said in a university news release.

The findings were based on a major review of data from 19 previously published studies. Those studies included more than 28 000 patients – the largest such study on the subject to date.

Vassiliou said his team focused on "outcomes for patients taking antihypertensives – looking particularly at what we call "critical" outcomes, such as being admitted to intensive care or being put on a ventilator, and death."

ACE inhibitors or ARBs were found to be very common medications.

"We found that a third of Covid-19 patients with high blood pressure and a quarter of patients overall were taking an ACEi/ARB. This is likely due to the increased risk of infection in patients with [preexisting illnesses] such as cardiovascular diseases, hypertension and diabetes," Vassiliou noted.

Reassuring findings

"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, and they might even improve outcomes.

Vassiliou stressed, however, that the findings do not mean the blood pressure meds should be used as a treatment for Covid-19 patients who aren't already taking them. "The mechanism of action might be different" in that context, he said.

One US expert called the study findings "reassuring" for patients who rely on these medications.

"It is comforting to know that these medications have a neutral effect on the severity of Covid infection," said Dr Guy Mintz, who directs cardiovascular health at Northwell Health's Sandra Atlas Bass Heart Hospital in Manhasset, New York.

No deleterious effects

It's unclear why taking an ACE inhibitor or an ARB might curb Covid-19, he said.

The drugs have anti-inflammatory effects "in addition to their blood pressure benefits. Could these effects neutralise some of the systemic inflammation due to Covid-19?" Mintz said. More study is needed, he believes.

In the meantime, Mintz said, "the take-home message here is if you develop Covid-19 infection, do not stop your ARB or ACE inhibitor. They are effective antihypertensive agents and have no deleterious effects in the setting of infection, and maybe afford patients a level of protection."

The report was published on 24 August in the journal Current Atherosclerosis Reports.

Image credit: iStock

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