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An analysis of data from 28,000 patients sheds more light on blood-pressure issues and COVID-19

‘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’

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By Quentin Fottrell, MarketWatch


AFP via Getty Images
‘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.’

People who need to take medication for high blood pressure appear to have improved survival rates for those suffering from COVID-19 and a less severe infection, according to new research from a team of scientists at the University of East Anglia in the U.K. and published Monday in the journal Current Atherosclerosis Reports, a bimonthly peer-reviewed medical journal.

The researchers studied the data from 28,000 patients taking antihypertensives — a class of drugs that are used to treat hypertension (high blood pressure) — and said the risk of death and a severe response to coronavirus infection was reduced for patients with high blood pressure who were taking Angiotensin-Converting Enzyme inhibitors (ACEi) or Angiotensin Receptor Blockers (ARB).

‘The chance of death/critical disease in patients taking ACEi/ARB was 33% lower than in those not taking them. Therefore the ACEi/ARB were beneficial.’

Lead researcher Dr. Vassilios Vassiliou, senior clinical lecturer in cardiovascular medicine at the University of East Anglia

“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,” said lead researcher Dr. Vassilios Vassiliou, senior clinical lecturer in cardiovascular medicine at the University of East Anglia’s Norwich Medical School, adding that people with cardiovascular issues were at more risk.

“The chance of death/critical disease in patients taking ACEi/ARB was 33% lower than in those not taking them. Therefore the ACEi/ARB were beneficial,” he told MarketWatch.

One important note of caution: Vassiliou cautioned that his team are NOT recommending that people start taking these medications. The limitations of the study focused solely on those who take these medications to deal with their blood pressure. “We are not able to address whether starting such tablets acutely in patients with COVID-19 might improve their prognosis, as the mechanism of action might be different,” he said.

The takeaway: It may indicate that people who already suffer from hypertension and take medication may be less at risk than those who have not taken measures to deal with their blood-pressure issues. People with high blood pressure have readings of more than 140 over 90 consistently. When treated for high blood pressure, most people aim for 130 over 80.

Nearly half of U.S. adults are at risk for major health problems due to high blood pressure, according to American Heart Association News guidelines. People with top readings of 130 or more or and bottom readings of 80 or more are considered to have high blood pressure. That accounts for approximately 46% of the population.

“The latest evidence shows that people with uncontrolled or untreated high blood pressure may be at risk of getting severely ill with COVID-19,” the Mayo Clinic said. “It’s also important to note that people with untreated high blood pressure seem to be more at risk of complications from COVID-19 than those whose high blood pressure is managed with medication.”

“We wanted to find out what the impact of these medications is for people with COVID-19,” Vassiliou said. “We therefore studied the 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.”

Dispatches from a pandemic: ‘I tried walking more than 3 blocks, paying the price with chest pains and crippling fatigue’: One woman’s long recovery from COVID-19

His team crunched data from 19 studies related to COVID-19, and ACEi and ARB medications. The meta-analysis involved more than 28,000 patients and, Vassiliou said, is the largest and most detailed such study to date. They compared data from COVID-19 patients who were taking ACEi or ARB medications with those who were not taking such medication.

“A third of COVID-19 patients with high blood pressure and a quarter of patients overall were taking an ACEi/ARBs,” he said. “This is likely due to the increasing risk of infection in patients with co-morbidities such as cardiovascular diseases, hypertension and diabetes. We showed was that there is no evidence that these medications might increase the severity of COVID-19 or risk of death.”

Early reports from COVID-19 hot spots, including Wuhan, Lombardy, and New York City, identified higher rates of hypertension among severely-ill, hospitalized COVID-19 patients.

Early reports from COVID-19 hot spots, including Wuhan, Lombardy, and New York City, identified higher rates of hypertension among severely ill, hospitalized COVID-19 patients, according to a separate review of studies by the American College of Cardiology. “A large U.S. study of 5,700 hospitalized patients revealed an overall hypertension rate of 56%,similar to hypertension rates reported from China and Italy (50% and 49%, respectively).”

But correlation does not equal causation. “Despite these observations, the link between hypertension and COVID-19 is unclear. Severity of COVID-19 illness is skewed towards the elderly population who have a higher prevalence of hypertension. The median age of hospitalized patients in Lombardy and New York City was 63 years old, and the percentage with a hypertension diagnosis is consistent with the percentage observed in the general population,” it said.

“While there is an over-representation of hypertension among hospitalized and critically-ill COVID-19 patients, it is uncertain whether this relationship is causal or confounded by age and other co-morbidities associated with hypertension including obesity, diabetes mellitus, and chronic kidney disease,” the review added.

Coronavirus update: As of Sunday, COVID-19 has now infected more than 25 million people worldwide, which mostly does not account for asymptomatic cases, and killed at least 842,892. The U.S. still has the world’s highest number of COVID-19 cases (5,961,582), followed by Brazil (3,846,153), India (3,542,733) and Russia (987,470), according to data aggregated by Johns Hopkins University.

The Dow Jones Industrial Index /zigman2/quotes/210598065/realtime DJIA +0.54% , the S&P 500 /zigman2/quotes/210599714/realtime SPX +0.52% and the Nasdaq Composite /zigman2/quotes/210598365/realtime COMP +0.19% ended higher Friday as the stock market is on track for best August in 36 years, framed largely by a speech from Federal Reserve Chairman Jerome Powell that likely ushered in an era of looser monetary policy after the central bank dropped its longstanding practice of preemptively lifting rates to head off higher inflation.

AstraZeneca /zigman2/quotes/200304487/composite AZN +0.76% , in combination with Oxford University; BioNTech SE /zigman2/quotes/214419716/composite BNTX -1.55% and partner Pfizer /zigman2/quotes/202877789/composite PFE +0.94% ; GlaxoSmithKline /zigman2/quotes/209463850/composite GSK -0.74% Johnson & Johnson /zigman2/quotes/201724570/composite JNJ +0.80% ; Merck & Co. ID:MERK -0.33% ; Moderna /zigman2/quotes/205619834/composite MRNA +3.61% ; and Sanofi /zigman2/quotes/202859081/composite SAN +1.51% are among those currently working toward COVID-19 vaccines. But experts caution that a vaccine is unlikely to provide 100% immunity to the population.

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Quentin Fottrell is MarketWatch's personal-finance editor and The Moneyist columnist for MarketWatch. You can follow him on Twitter @quantanamo.

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