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WASHINGTON (AFP) – Commonly used blood pressure medications do not increase susceptibility to Covid-19 infection, nor increase the risk of becoming seriously ill, three major studies said on Friday (May 1), positive news for millions of people who take them away.
The research focused primarily on angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (BRAs), which are also administered to patients with diabetes to help protect their kidneys.
ACE inhibitors include ramipril, lisinopril, and other drugs that end in -pril; while ARBs include valsartan and losartan, and generally end in -sartan.
Concerns arose in animal studies that these drugs could increase body levels of a protein called ACE2, which the coronavirus clings to when it invades human cells, thereby increasing people’s vulnerability to the disease.
Even more confusing, there were also conflicting animal studies showing that having more ACE2 proteins could lessen an inflammatory reaction in the lungs to Covid-19, a beneficial effect.
The three new studies were published in the New England Journal of Medicine (NEJM).
Each included reviewing the records of thousands of people with or without medications and looking at whether they became infected and how the disease progressed.
They then used statistical methods to control for other factors such as underlying health conditions that could make people more susceptible to infection and severe Covid-19.
“We saw no difference in the likelihood of a positive test with ACE inhibitors and angiotensin receptor blockers,” Harmony Reynolds of the NYU Grossman School of Medicine, who led one of the studies that involved the study, told AFP. to about 12,600 people.
The studies were “observational,” meaning that the researchers looked at the effect of a risk factor.
This type of research is always considered weaker than “experimental”, where an intervention is introduced along with a control, leaving less to chance.
The authors of an accompanying editorial in the NEJM recognized this inherent limitation, but added: “We find it reassuring that three studies in different populations and with different designs reach the coherent message.” Reynolds said the findings were relieving, because she had received questions from concerned patients who had read press reports and asked if they should stop their medications.
“I am very happy to be able to tell patients that they should continue their blood pressure medications,” he said.
This is especially important given that confinement life itself appears to be causing high blood pressure, “perhaps due to stress or less exercise or eating differently,” he added.
Mandeep Mehra, medical director of the Cardiac and Vascular Center at Brigham and Women’s Hospital (BWH) who led another study, said another fundamental question had been answered.
At the beginning of the pandemic, when it became clear that people with cardiovascular conditions were more likely to get severe Covid-19, the scientists wondered: was heart disease the risk factor or the medication used to control it?
The new investigation firmly resolves the debate in favor of the first, he said.
“It tells you beyond a doubt that Covid-19 somehow interacts with the cardiovascular system in quite a negative way,” Mehra said.
POTENTIAL BENEFIT?
Mehra’s study, which looked at nearly 9,000 patients in 11 countries, also linked blood pressure medication use to a lower risk of death from Covid-19, a finding not shared by the other two studies.
“The same drugs that appear to have life-saving benefits in patients with cardiovascular disease also appear to show a sign of benefit in patients who are in the throes of Covid-19,” he said.
He added that it was not clear why this was the case, either because the drugs were helping the heart, which in turn made it more resistant to the effects of the virus, or if they were doing something else.
“What we can tell you is that if you are taking a statin or an ACE inhibitor, please continue,” added Mehra.
According to official figures, almost half of adults in the United States, or 108 million people, have hypertension.
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