People with high blood pressure should keep taking their drugs in COVID-19 pandemic

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In two new papers, cardiologists from Wuhan, China, and other nations urge people with high blood pressure to continue taking their medications even though some have been implicated in COVID-19 infections.

Angiotensin-converting enzyme inhibitors (ACE-i or ACEI) or angiotensin receptor blocker (ARB) medications are prescribed for conditions such as heart failure, hypertension or heart disease.

This information further confirms the guidance provided in a March 17 statement by the American Heart Association, the Heart Failure Society of America and the American College of Cardiology.

Cardiologists in Wuhan, China, where COVID-19 originated, note that while it has been suggested that these medications might lead to an increased risk of COVID-19, the medications play a critical role in many cardiovascular conditions.

They say ACE2 plays a protective role in both heart diseases and acute lung injury.

For uninfected patients, it is unnecessary to discontinue ACEIs/ARBs given the lack of evidence to support the hypothesis that ACEIs/ARBs might lead to an increased risk of COVID-19 infection.

For infected patients, although higher ACE2 expression might be linked to higher viral loads, ACEIs/ARBs should not be discontinued assertively because they can block the RAS [renin-angiotensin system] and protect patients from the potential heart injuries in COVID-19 and might also reduce the severity of lung damage caused by the infection.

However, there is no immediate need to initiate ACEIs/ARBs because there has been no definitive evidence that they benefit COVID-19 patients’ survival.”

In a second article, a group of researchers from Switzerland, Germany and New York says it is a “double-edged sword,” and they support the position of professional cardiology societies including the American Heart Association to continue ACE-i and ARBs.

The group notes that “discontinuation of these drugs may exacerbate frank heart failure.”

The papers are published in the Journal of the American Heart Association.

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