Photo credit: Copyright American Heart Association
It has been speculated that two types of drugs used to treat high blood pressure and heart failure – angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) – might increase the risk of contraction COVID-19.
Researchers examined MEDLINE and EMBASE databases for studies detailing patients treated with ACE inhibitors and / or ARB drugs. They performed two meta-analyzes to evaluate the results of 17 studies: 1) to examine the rate of COVID-19 positive cases and 2) to determine the death rate among those hospitalized with COVID-19.
Their analyzes showed the following results:
- Patients who took ACE inhibitors or ARBs did not have an increased COVID-19 infection rate; and
- Hospitalized COVID-19 patients taking ACE inhibitors or ARBs did not have an increased death rate.
An under-analysis was also performed, focusing on the studies of patients treated for high blood pressure. The results show that use of ACE inhibitors and ARBs was associated with a lower death rate in hospitalized COVID-19 patients with a history of hypertension.
“Our study results confirm that patients who are already taking ACE inhibitors and ARBs should not stop taking them because of COVID-19 infection,” said lead study author Yujiro Yokoyama, MD, a surgeon at Easton Hospital at St. Luke’s University Health Network in Pennsylvania. “Both drugs have been shown to be beneficial for heart and kidney disease, and this confirms previous findings that ACE inhibitors do not pose an additional risk with COVID-19.”
Prescription blood pressure bottle and pills. Photo credit: Copyright American Heart Association
At the onset of the COVID-19 pandemic, the American Heart Association made a joint statement with the Heart Failure Society of America and the American College of Cardiology to end the use of ACE inhibitors and ARB drugs in patients at risk for development of COVID-19 to investigate. The recommendations called for the continuation of ACE-i or ARB drugs in patients who are already taking them for indications such as heart failure, high blood pressure or ischemic heart disease. Patients with cardiovascular disease diagnosed with COVID-19 should be fully evaluated before adding or removing treatments. Changes to your treatment should be based on the latest scientific evidence and shared decisions with your doctor and health team.
Meta-analyzes on the effect of renin-angiotensin-aldosterone system inhibitors on mortality and the testing of Covid-19-positive (presentation 399)
Co-authors of the study are Dr. med. Hisato Takagi; Tadao Aikawa, MD, Ph.D .; and Toshiki Kuno, MD, Ph.D. The information provided by the authors is listed in the summary. No external funding sources were indicated for this study.
Note: Session: CV19.AOS.848 – COVID-19: Risk Assessments and Risk Factors for Adverse Results
As the COVID-19 pandemic continues to affect people around the world, research is now being carried out to provide a better understanding of the virus and improve patient care and outcomes. Heart health and medication, and the potential role everyone plays in patients with COVID-19, have been the focus of hundreds of studies. The American Heart Association will host experts who will share the latest COVID-19 research at their 2020 scientific sessions. The meeting will take place virtually from Friday, November 13 through Tuesday, November 17, 2020 and is a leading global exchange of the latest scientific advances, research and evidence-based clinical practice updates in cardiovascular science for healthcare worldwide.
