There has been speculation that two types of medications used to treat high blood pressure and heart failure — angiotensin-converting enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) — may increase the risk of contracting COVID-19.
The researchers examined MEDLINE and EMBASE databases for studies that detailed patients treated with ACE inhibitors and/or ARB medications. They conducted two meta-analyses to evaluate the results of 17 trials: 1) to investigate the rate of COVID-19 positive cases, and 2) to determine the death rate among those hospitalized with COVID-19.
Their analyses yielded these findings:
- Patients taking ACE inhibitors or ARBs did not have an increased rate of COVID-19 infection; and
- Hospitalized COVID-19 patients taking ACE inhibitors or ARBs did not have an increased rate of death.
A sub-analysis was also done, focused on the studies including patients treated for hypertension. The results indicate taking ACE inhibitors and ARBs was associated with a lower death rate among hospitalized COVID-19 patients with a history of hypertension.
“Our study results confirm that patients already taking ACE inhibitors and ARBs should not discontinue taking them due to COVID-19 infection,” said lead study author Yujiro Yokoyama, M.D., a surgeon at St. Luke’s University Health Network’s Easton Hospital in Pennsylvania. “Both medications have proven benefits for heart and kidney disease, and this further confirms previous findings that ACE inhibitors do not pose additional risk with COVID-19.”
Early in the COVID-19 pandemic, the American Heart Association issued a joint statement with the Heart Failure Society of America and the American College of Cardiology to address the use of ACE inhibitors and ARB medications among patients at risk for developing COVID-19. The recommendations called for the continuation of ACE-i or ARB medications among patients already taking them for indications such as heart failure, hypertension, or ischemic heart disease. Cardiovascular disease patients who are diagnosed with COVID-19 should be fully evaluated before adding or removing any treatments, and any changes to their treatment should be based on the latest scientific evidence and shared decision-making with their physician and health care team.
Meta-analyses for the Effect of Renin-angiotensin-aldosterone System Inhibitors on Mortality and Testing Positive for Covid-19 (Presentation 399)
Co-authors of the study are Hisato Takagi, M.D., Ph.D.; Tadao Aikawa, M.D., Ph.D.; and Toshiki Kuno, M.D., Ph.D. The authors’ disclosures are detailed in the abstract. No external funding sources were noted for this study.
Note: Session: CV19.AOS.848 – COVID-19: Risk Scores and Risk Factors for Adverse Outcomes
As the COVID-19 pandemic continues to affect people around the globe, research is ongoing to facilitate a greater understanding of the virus to improve patient care and outcomes. Heart health and medications and the potential role each has on patients with COVID-19 have been the focus of hundreds of studies. The American Heart Association will host experts presenting the latest COVID-19 research at its Scientific Sessions 2020. The meeting will be held virtually, Friday, November 13 – Tuesday, November 17, 2020, and is a premier global exchange of the latest scientific advancements, research, and evidence-based clinical practice updates in cardiovascular science for health care worldwide.
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