Medications to treat high blood pressure did not affect outcomes among patients hospitalized with COVID-19, found an international team led by researchers in the Perelman School of Medicine. The study, published in The Lancet Respiratory Medicine, is the first randomized controlled trial to show there is no risk for patients continuing these medications while hospitalized for COVID-19.
As part of the REPLACE COVID trial, investigators examined whether ACE inhibitors (ACEIs) or Angiotensin Receptor Blockers (ARBs)—two classes of medications to treat high blood pressure—could help mitigate complications or lead to more severe symptoms. More than 49 million U.S. adults take medication to treat hypertension, and among those, about 83% (41 million) take an ACEI or ARB, according to the Centers for Disease Control and Prevention.
Early during the pandemic, a concern arose regarding the use of ACEIs or ARBs in the setting of COVID-19, since some studies had suggested that these medications could upregulate cellular receptors for the SARS-CoV-2 virus, potentially aiding viral replication. However, it was also considered that some effects of these medications could be protective against the virus.
“Observational studies were rapidly done, but randomized trials are important to establish a definitive answer regarding the potential impact of these commonly used blood pressure medications in the setting of COVID-19,” says study corresponding and senior author Julio A. Chirinos, an associate professor of cardiovascular medicine in the Perelman School of Medicine. “Our trial results importantly show that these medications can be safely continued for patients hospitalized with COVID-19.”
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