Coronavirus Treatment: Blood Pressure Medicines May Reduce COVID-19 Severity, Deaths: Study

People taking a popular class of high-blood pressure medicine are at a reduced risk of severe COVID-19 illness and death, new research reveals.

A study from the University of East Anglia in Norwich, England finds the risk of severe COVID-19 illness and death is reduced for patients with high blood pressure taking Angiotensin-Converting Enzyme inhibitors (ACEi) or Angiotensin Receptor Blockers (ARB).

ACEi relaxes blood vessels and decreases blood volume. This combined action leads to lower blood pressure and decreased oxygen demand from the heart. On the other hand, ARBs block receptors affected by the hormone, Angiotensin II. Its targets are AT1 receptors found in the heart, blood vessels and kidneys. Blocking the action of Angiotensin II helps lower blood pressure and prevents damage to the heart and kidneys.

Among the ACEis available in the U.S. are benazepril, lisinopril, perindopril, quinapril, ramipril and trandolapril. ARBs sold in the nation include azilsartan, candesartan, eprosartan, irbesartan,losartan, olmesartan, telmisartan and valsartan.

Researchers studied 28,000 patients taking antihypertensives to find out if those with cardiovascular diseases are at particular risk of severe COVID-19 infection. 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 from UEA’s Norwich Medical School.

Using meta-analysis, the research team analyzed data from 19 studies related to COVID-19 and ACEi and ARB medications. The study is largest and most detailed such study to date.

Researchers compared data from COVID-19 patients taking ACEi or ARB medications with those who were not. Their focus was on whether patients experienced critical events such as admission to intensive care and invasive or non-invasive ventilation, and death.

Researchers found that a third of COVID-19 patients with high blood pressure and a quarter of patients overall were taking either an ACEi or ARB. Dr. Vassiliou said the important finding shows there is no evidence these medications might increase the severity of COVID-19 or risk of death.

“On the contrary, we found that there was a significantly lower risk of death and critical outcomes, so they might in fact have a protective role -- particularly in patients with hypertension," he said.

Vassiliou pointed out COVID-19 patients with high blood pressure taking ACEi or ARB medications were 0.67 times less likely to have a critical or fatal outcome than those not taking these medications.

“Our research provides substantial evidence to recommend continued use of these medications if the patients were taking them already," noted Vassiliou.

The study, however, was unable to address the issue as to whether giving ACEi or ARB medications to patients with COVID-19 might improve their prognosis since the mechanism of action might be different.

The research was led by UEA in collaboration with the Norfolk and Norwich University Hospital. The study carries the title, "Effect of Renin-Angiotensin-Aldosterone System Inhibitors in Patients with COVID-19: a Systematic Review and Meta-analysis of 28,872 Patients."