In general, the authors conclude that, as it stands, there is no firm proof that hypertension or blood pressure drugs will increase a person’s danger of contracting SARS-CoV-2. Similarly, existing evidence does not support the theory that people with high blood pressure are more likely to experience even worse symptoms of COVID-19 should they contract the infection.
Research studies have actually shown that certain existing conditions are related to an increased danger of contracting SARS-CoV-2 and with more serious signs of COVID-19
For instance, a research study that examined 41 patients in Wuhan, China, discovered that 32%had underlying health conditions– most typically, diabetes, hypertension, and cardiovascular disease.
Another study, which appears in JAMA Internal Medication, followed 201 people with COVID-19 Of these people, 84 developed severe respiratory distress syndrome (ARDS). Of the 84 who established ARDS, 27.4%had high blood pressure. In contrast, 13.7%of those who did not develop ARDS had hypertension.
However, these associations between hypertension and COVID-19 are not always causal. As the authors of the current commentary discuss:
“[H] ypertension is extremely regular in the senior, and older individuals seem at particular danger of being contaminated with SARS-CoV-2 infection and of experiencing serious forms and complications of COVID-19”
In the JAMA study, the average age of individuals who developed ARDS was 58 years compared to 48 years in those who did not establish ARDS. Simply put, the concerns surrounding hypertension and COVID-19 danger require more examination.
For individuals with high blood pressure, physicians in some cases recommend angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs). These medications come from a group of drugs called renin-angiotensin-aldosterone system (RAAS) antagonists.
These drugs hinder the RAAS and interrupt activity at a receptor called ACE2. Researchers have actually revealed that SARS-CoV-2 binds to ACE2 receptors to facilitate its entry into lung cells. This coincidence raises some interesting questions.
There is some proof that ACE inhibitors and ARBs increase the number of ACE2 receptors. As the authors describe, this “might theoretically increase the binding of SARS-CoV-2 to the lung and its pathophysiological effects, leading to greater lung injury.” Simply put, if these drugs increase the number of entry points for the virus, they may cause more serious symptoms.
Nevertheless, in opposition to this theory, some research study indicates that ACE2 can safeguard against serious lung injury. Along comparable lines, the authors of the current commentary discuss that, due to interactions with the RAAS, both ACE inhibitors and ARBs may “add to reduce inflammation systemically and particularly in the lung, heart, and kidney.”
If this is the case, the drugs “could decrease the capacity for advancement of either acute respiratory distress syndrome, myocarditis, or acute kidney injury, which can take place in COVID-19 clients.”
In truth, some researchers have actually recommended ARBs as a potential treatment for COVID-19
Other scientists have actually proposed soluble ACE2 as a treatment. As SARS-CoV-2 binds to ACE2 receptors, increased levels of circulating ACE2 may help “mop up” the virus, avoiding it from reaching the lungs and other organs that bear the ACE2 receptor.
To date, however, researchers have actually not checked these techniques in people.
As it stands, main bodies advise continuing medication for high blood pressure. The Heart Failure Society of America, the American College of Cardiology, and the American Heart Association advise “extension of RAAS villains for those clients who are presently recommended such agents for indicators for which these representatives are understood to be helpful, such as heart failure, high blood pressure, or ischemic heart illness.”
In general, numerous questions remain. Since yet, there is inadequate evidence to conclude definitively that hypertension increases COVID-19 danger. When it comes to high blood pressure medications, they might ward off SARS-CoV-2, make COVID-19 worse, or not affect the infection at all. The authors of the brand-new commentary conclude:
“[T] here is, yet, no proof that hypertension is associated with outcomes of COVID-19 or that ACE inhibitor or ARB usage is hazardous, or, for that matter, beneficial, during the COVID-19 pandemic.”
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