This answers my previous post, treated or untreated hypertension?
Hypertension drugs do not hike risk of severe illness in COVID-19 cases
Reuters Health News | April 24, 2020
Hypertensive patients with COVID-19 can
safely continue to take their angiotensin-converting enzyme (ACE)
inhibitors or angiotensin receptor blockers (ARBs) without increasing
their risk of dying from the coronavirus, retrospective data from China
suggest.
The single-center study of 1,178 COVID-19 patients treated from January 15 to March 15 included 362 patients with hypertension, 115 of whom were taking renin-angiotensin-aldosterone system (RAAS) antagonists. There was "no difference in severity of the disease, complications, and risk of death in those who were taking ACEIs/ARBs compared with those not treated with these medications," researchers report in JAMA Cardiology.
The researchers did find that patients with hypertension had triple the odds of death compared with other patients with COVID-19.
The findings offer reassurance that the current recommendation for infected patients to continue taking their ACE inhibitors and ARBs is sound. There had been concern because the virus uses ACE2 receptors as an entry point to infect cells.
Doctors at Central Hospital of Wuhan found the proportion of patients with hypertension taking ACE inhibitors or ARBs did not differ between those with severe and nonsevere infections (32.9% vs 30.7%; P = 0.645) or between nonsurvivors and survivors (27.3% vs 33.0%; P = 0.34).
When the research team, led by Dr. Juyi Li of Huazhong University of Science and Technology, looked at ACE inhibitors and angiotensin receptor blockers individually, the results were similar.
High blood pressure was a major risk factor for COVID-19 patients at the Central Hospital. While the overall mortality rate in the hospital was 11.0%, it was 21.3% for patients with hypertension. The death rate was 6.5% among coronavirus patients without hypertension.
When the researchers broke down the data based on the class of blood pressure drug, 9.2% with severe illness and 10.1% with non-severe illness were taking an ACE inhibitor (P=0.80). Similarly, 9.1% of those who died were ACE inhibitor recipients versus 9.8% of those who survived (P=.85).
ARB patients made up 24.9% of those with severe illness and 21.2% of those with non-severe disease (P=0.40). They also represented 19.5% of patients who died vs 23.9% who survived (P=0.42).
Among patients who also had coronary heart disease, diabetes, cerebrovascular disease, neurological disease, and chronic renal disease, "the frequency of severe illness and death did not differ between those treated with or without" ACE inhibitors or ARBs, the Li team concluded.
The findings also confirm "that patients with hypertension have more severe illness and higher mortality rates than those without hypertension," they said. "We found that patients with hypertension had more than three times the mortality rate of all other patients hospitalized with COVID-19."
The researchers defined severe illness as blood oxygen saturation levels of 93% or less, a partial pressure of arterial oxygen to fraction of inspired oxygen ratio of less than 300, a respiratory frequency of 30 breaths per minute or greater, lung infiltrates of more than 50% within 24 to 48 hours, septic shock, respiratory failure, and/or multiple organ dysfunction or failure.
Senior author Aiping Deng did not respond to emailed questions from Reuters Health.
—Reuters Staff
The single-center study of 1,178 COVID-19 patients treated from January 15 to March 15 included 362 patients with hypertension, 115 of whom were taking renin-angiotensin-aldosterone system (RAAS) antagonists. There was "no difference in severity of the disease, complications, and risk of death in those who were taking ACEIs/ARBs compared with those not treated with these medications," researchers report in JAMA Cardiology.
The researchers did find that patients with hypertension had triple the odds of death compared with other patients with COVID-19.
The findings offer reassurance that the current recommendation for infected patients to continue taking their ACE inhibitors and ARBs is sound. There had been concern because the virus uses ACE2 receptors as an entry point to infect cells.
Doctors at Central Hospital of Wuhan found the proportion of patients with hypertension taking ACE inhibitors or ARBs did not differ between those with severe and nonsevere infections (32.9% vs 30.7%; P = 0.645) or between nonsurvivors and survivors (27.3% vs 33.0%; P = 0.34).
When the research team, led by Dr. Juyi Li of Huazhong University of Science and Technology, looked at ACE inhibitors and angiotensin receptor blockers individually, the results were similar.
High blood pressure was a major risk factor for COVID-19 patients at the Central Hospital. While the overall mortality rate in the hospital was 11.0%, it was 21.3% for patients with hypertension. The death rate was 6.5% among coronavirus patients without hypertension.
When the researchers broke down the data based on the class of blood pressure drug, 9.2% with severe illness and 10.1% with non-severe illness were taking an ACE inhibitor (P=0.80). Similarly, 9.1% of those who died were ACE inhibitor recipients versus 9.8% of those who survived (P=.85).
ARB patients made up 24.9% of those with severe illness and 21.2% of those with non-severe disease (P=0.40). They also represented 19.5% of patients who died vs 23.9% who survived (P=0.42).
Among patients who also had coronary heart disease, diabetes, cerebrovascular disease, neurological disease, and chronic renal disease, "the frequency of severe illness and death did not differ between those treated with or without" ACE inhibitors or ARBs, the Li team concluded.
The findings also confirm "that patients with hypertension have more severe illness and higher mortality rates than those without hypertension," they said. "We found that patients with hypertension had more than three times the mortality rate of all other patients hospitalized with COVID-19."
The researchers defined severe illness as blood oxygen saturation levels of 93% or less, a partial pressure of arterial oxygen to fraction of inspired oxygen ratio of less than 300, a respiratory frequency of 30 breaths per minute or greater, lung infiltrates of more than 50% within 24 to 48 hours, septic shock, respiratory failure, and/or multiple organ dysfunction or failure.
Senior author Aiping Deng did not respond to emailed questions from Reuters Health.
—Reuters Staff
To read more, click here.
No comments:
Post a Comment