Lara Adejoro
A new study states that two popular hypertension drugs are safe for users who are hospitalised after contracting COVID-19.
The study offered reassuring evidence to people living with high blood pressure that the hypertension drugs do not put them at risk on account of undergoing treatment for COVID-19.
According to the study, at the start of the pandemic, patients were worried about the harm that two blood pressure-lowering drugs — ACE inhibitors or Angiotensin Receptor Blockers — can cause.
However, experts say evidence has shown that the drugs do not affect the outcomes of people hospitalised with COVID-19.
The study, first published in The Lancet Respiratory Medicine, involved 152 participants – 75 participants were randomly assigned to the continuation of ACEI or ARB therapy and 77 participants were randomly assigned to discontinuation of ACEI or ARB therapy and were included in the intention-to-treat analyses.
The median duration of hospitalisation, and thus randomly assigned treatment allocation, was five days. The investigators found no difference in outcomes between the two groups.
As reported by online journal Medicine Net, “At the start of the pandemic, patients were worried about perceived harm based on limited and incomplete information and, unfortunately, some insisted on stopping their medications,” said study first author Dr. Jordana Cohen, an assistant professor in the university’s Perelman School of Medicine.
“However, stopping these medications unnecessarily can increase the risk for severe complications, including heart attack and stroke,” Cohen said.
Continuing, he said, “Now, we have high-quality evidence to support our recommendation that patients continue to take these medications as prescribed.”
“Our trial results importantly show that these medications can be safely continued for patients hospitalised with COVID-19,” researchers from the University of Pennsylvania added.
Also, speaking with PUNCH HealthWise, a Consultant Cardiologist at the Lagos State University Teaching Hospital, Ikeja, Dr. Ramon Moronkola, said further analysis has shown that the anti-hypertensive class of drugs does not affect outcomes of people hospitalised with COVID-19.
“At the initial stage, it was thought that people that take the medications are at risk of COVID-19 infection or possibility of increased mortality.
“However, subsequent research and analysis have shown that there is no impact and it is rather protective.
“The reason is that patients with COVID-19 are prone to cardiac conditions and it can directly affect the heart, apart from the fact that it can worsen the condition.
“These two medications have shown to offer protection for people that have cardiac disease, which means that it can prolong longevity.
“So, since people who have COVID-19 can also develop cardiac complications, these drugs can protect their hearts.
“It has now been agreed that it is protective, rather than causing more harm for patients with COVID-19,” Moronkola said.
He added that medicine is dynamic and that it involves continuous research that will inform the treatment decision of caregivers.
“The fact that there was speculation does not mean that it was cast in stone. Subsequent research has shown that it is protective,” he said.
The study, led by Jordana Cohen, showed that the continuation of ACEI or ARB therapy among patients admitted to hospital with COVID-19 had no overall effect on the severity of the COVID-19 disease course.
“We observed no significant difference in the primary hierarchical endpoint between participants who continued their ACEI or ARB therapy compared with those who discontinued therapy.
“Secondary and subgroup analyses were otherwise consistent with our primary endpoint, showing no difference in length of COVID-19 hospitalisation, need for intensive care, invasive mechanical ventilation, or death between treatment groups.
“Multiorgan dysfunction, as depicted by the AUC of the modified SOFA score, was also similar across treatment groups. Furthermore, we observed no difference in blood pressure control, serum potassium, or serum creatinine over the course of follow-up among patients whose ACEI or ARB therapy was continued versus discontinued,” the researchers noted.
The researchers concluded that among patients admitted to hospital with COVID-19, continuation, and discontinuation of the renin-angiotensin system inhibitors have similar effects on acute hospitalisation outcomes.
“Consistent with current international society recommendations, providers should continue to prescribe these medications in patients admitted to hospital with COVID-19 unless there is a distinct medical contraindication to ongoing therapy. Ongoing trials will determine whether de novo use of these medications is effective for the treatment of COVID-19;” they submitted.
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