Study Finds No Link Between Blood Pressure Medications and Increased Risk for Patients with COVID-19

Recent study results showed that common medications used for treating high blood pressure did not increase the risk of contracting the coronavirus disease 2019 (COVID-19) and did not increase the risk of developing more severe disease. These study results are significant because some experts had expressed concerns about the safety of these drugs for patients with the disease.¹

The study was launched in response to an earlier joint statement issued by the American Heart Association, the American College of Cardiology, and the Heart Failure Society of America, which urged more research on the subject. Earlier studies had raised questions about the use of hypertension drugs.¹

“With nearly half of American adults having high blood pressure, and heart disease patients more vulnerable to COVID-19, understanding the relationship between these commonly used medications and COVID-19 was a critical public health concern,” said lead investigator Harmony R. Reynolds, MD, associate director of the Cardiovascular Clinical Research Center at New York University (NYU) Langone Health, in a statement.¹

The investigators researched the use of 4 drug classes: angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), beta blockers, and calcium channel blockers. These medications act on the renin-angiotensin-aldosterone hormonal system, which influences blood pressure, according to the authors.²

Notably, a version of ACE—ACE2—is found in the outer membrane of lung cells, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been shown to connect to ACE2 on lung cells in an early step toward viral infection.²

The investigators studied patients in the NYU Langone Health electronic record system who had COVID-19 test results recorded between March 1, 2020 and April 15, 2020. Researchers found that of 12,594 patients who were tested for COVID-19, 5894 were positive; and 1002 of these patients had severe illness. A history of hypertension was present in 4357 of tested patients, among whom 2573 had a positive test; and 634 of these patients had severe illness. The investigators concluded there was no association between any single medication class and an increased likelihood of a positive test. None of the medications examined was associated with a substantial increase in the risk of severe illness among patients who tested positive.²

Most notably, the investigators found no association between any of the medications and an increased likelihood of a positive test or a substantial increase in the risk of severe illness among those who tested positive.²

They did note a slightly lower likelihood of a positive test among patients taking beta-blockers and said it may be attributable to effects of beta-blockers on the expression of presentation of the cell surface of ACE2.²

“Our findings should reassure the medical community and patients about the continued use of these commonly prescribed medications, which prevent potentially severe heart events in their own right,” Reynolds said.¹

REFERENCES

• Study Funds High Blood Pressure Medications Safe for Patients with COVID-19 Disease [news release]. NYU Langone Health; May 1, 2020. https://nyulangone.org/news/study-finds-high-blood-pressure-medications-safe-patients-covid-19-disease. Accessed May 11, 2020.
• Reynolds H, Adhikari S, Pulgarin C, et al. Renin-Angiotensin-Aldosterone System Inhibitors and Risk of Covid-19. New England Journal of Medicine; May 1, 2020. https://www.nejm.org/doi/10.1056/NEJMoa2008975. Accessed May 11, 2020.