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ARBs, ACEIs useful for treating COVID-19 patients with pre-existing hypertension

23 May 2020

Angiotensin II receptor blockers (ARBs) or angiotensin-converting enzyme inhibitors (ACEIs) show superiority over other blood pressure (BP)-lowering medications in terms of reducing high-sensitivity C-reactive protein (hs-CRP) and procalcitonin levels in COVID-19 patients with pre-existing hypertension, as shown in a recent study.

The retrospective analysis included 126 hypertensive COVID-19 patients (median age, 66 years; 49.2 percent male) who received treatment with ARBs/ACEIs (n=43) or non-ARBs/ACEIs (n=83) and 125 matched nonhypertensive COVID-19 controls (median age, 66 years; 48.8 percent male). Researchers also reviewed the medication history of 1,942 hypertensive patients (non-COVID-19) hospitalized prior to the outbreak for external comparison.

Compared with controls, hypertensive patients had higher levels of systolic and diastolic blood pressure (125/75 vs 120/70 mm Hg; p=0.031 and p=0.004, respectively) and were more likely to have diabetes (30.2 percent vs 13.6 percent; p=0.002) and cardiopathy (18.3 percent vs 9.6 percent; p=0.048).

Of note, the frequency of ARBs/ACEIs usage was similar in hypertensive patients with and without COVID-19 (34.1 percent vs 35.4 percent; p=0.767).

In the group of COVID-19 patients with hypertension, BP did not significantly differ between those who received ARBs/ACEIs and those on non-ARBs/ACEIs. However, treatment with ARBs/ACEIs was associated with significantly lower concentrations of hs-CRP (p=0.049) and procalcitonin (p=0.008), as well as numerically fewer critically ill patients (9.3 percent vs 22.9 percent; p=0.061) and a lower number of deaths (4.7 percent vs 13.3 percent; p=0.216).

The present data support the use of ARBs/ACEIs over other antihypertensive drugs in the treatment of COVID-19 patients with hypertension, researchers said. Large prospective studies are needed to validate the results and to explore the mechanisms by which ARBs/ACEIs regulate the inflammatory response.

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Most Read Articles
11 Aug 2020
During the Allergic Rhinitis (AR) Boot Camp held in conjunction with the Bayer Pharmacist Congress 2020, Professor Dr Baharudin Abdullah discussed the management of AR in the primary care setting and the importance of using patient profiles to guide the choice of antihistamines.
Elaine Soliven, 3 days ago
Adding mepolizumab to standard of care treatment significantly reduces nasal polyp size and obstruction in adults with chronic rhinosinusitis with nasal polyps (CRSwNP), according to the SYNAPSE* study presented at ERS 2020.
5 days ago
OZEMPIC – Semaglutide 1.34 mg/mL soln for inj
Audrey Abella, 11 Sep 2020
A prasugrel de-escalation strategy significantly reduced the risk of NACE* and bleeding events in patients with ACS** after PCI*** compared with the conventional strategy, results of the HOST-REDUCE-POLYTECH-ACS# trial have shown.