Why people with high blood pressure more likely to have severe COVID-19

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COVID-19 patients who also suffer from high blood pressure are more likely to fall severely ill with the disease, which also leaves them at greater risk of death.

In a new study, researchers found that the immune cells of patients with hypertension are already pre-activated and that this pre-activation is greatly enhanced under COVID-19.

This most likely explains the augmented response of the immune system and the more severe disease progression.

However, certain hypertension-reducing drugs known as ACE inhibitors can have a beneficial effect.

They not only lower blood pressure but also counteract immune hyperactivation.

The research was conducted by a team from the Berlin Institute of Health (BIH) and elsewhere.

More than one billion people worldwide suffer from high blood pressure or hypertension.

Of the more than 75 million people around the world who have become infected with the SARS-CoV-2 virus worldwide so far, more than 16 million also have hypertension.

These patients are more likely to become severely ill, which in turn results in an increased risk of death.

It was previously unclear to what extent treatment with antihypertensive drugs could be continued during a SARS-CoV-2 infection—and whether they were more likely to benefit or harm the patients.

This is because antihypertensives interfere with the exact same regulatory mechanism that the novel coronavirus SARS-CoV-2 uses to enter the host cell and trigger COVID-19.

In the study, the team analyzed individual cells from the respiratory systems of COVID-19 patients who were also taking medication for high blood pressure.

They found that the drugs do not seem to cause more receptors to form on the cells.

In fact, heart patients taking ACE inhibitors actually displayed a lower risk of becoming severely ill with COVID-19.

The scientists found that anti-hypertensive drugs can also impact how quickly the immune system is able to reduce the viral load, i.e., the concentration of the virus in the body.

More than 40 scientists have been working at a breakneck pace on this extensive study.

The team hopes to provide a scientifically sound answer as quickly as possible to the question of whether simultaneous treatment with ACE inhibitors or angiotensin receptor blockers could have beneficial or even adverse effects during the COVID-19 pandemic.

One author of the study is Professor Ulf Landmesser.

The study is published in Nature Biotechnology.

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