NYU Study Finds High Blood Pressure Medications Use Safe with COVID-19

Research from New York University (NYU) Grossman School of Medicine found no link between treatment with 4 drug classes-angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), beta blockers, or calcium channel blockers-and increased risk for becoming infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes the novel coronavirus disease 2019 (COVID-19).¹

The study also reported no significant increase in risk for severe COVID-19 infection, including intensive care, requiring a ventilator, and death, in individuals being treated with high blood pressure medications.¹

Authors of the study stressed the significance of the findings due to the increasing prevalence of high blood pressure and cardiovascular disease (CVD) in the United States “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 NYU Langone Health, in a statement.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.”

NYU prioritized the study following a joint statement made by the American Heart Association, the American College of Cardiology, and the Heart Failure Society of America, which highlighted the immediate need for research to confirm the role of high blood pressure medications on COVID-19 patient outcomes.²

The joint statement expressed concerns about the lack of clinical data showing beneficial or adverse outcomes among COVID-19 patients using ACE-1 or ARB medications.³

The study therefore focused on medication that acts on the renin-angiotensin-aldosterone hormonal system, which affects an individual’s blood pressure. Levels of the signaling protein angiotensin II are controlled by ACE, and SARS-CoV-2 has been shown to connect to ACE2-a version of ACE. Prior to the NYU study, experts in the field reasoned that ACE inhibitors and ARBS may increase or worsen COVID-19 symptoms.¹

The study incorporated 12,594 patients in the NYU Langone electronic health record with COVID-19 test results and compared participants treated with high blood pressure medications with those who are not.¹

“Before our study, there were no experimental or clinical data demonstrating the consequences of using these medications one way or the other in people at risk for COVID-19,” said senior study author Judith S. Hochman, MD, the Harold Snyder Family Professor of Cardiology in the Department of Medicine and senior associate dean for clinical sciences at NYU Langone.² “In terms of next steps, our plan is to use similar approaches to investigate other medications and their relationship to COVID-19 illness.”

Results of the study have been published in the New England Journal of Medicine.

References:

1. Reynolds HR, Adhikari S, Pulgarin C, et al. Renin-angiotensin-aldosterone system inhibitors and risk of Covid-19. New England Journal of Medicine. May 1, 2020. Doi: 10.1056/NEJMoa2008975
2. Study Finds High Blood Pressure Medications Safe for Patients with COVID-19 Disease. News Release. NYU Langone Health; May 1, 2020. Accessed May 5, 2020. https://nyulangone.org/news/study-finds-high-blood-pressure-medications-safe-patients-covid-19-disease.
3. HFSA/ACC/AHA Statement Addresses Concerns Re: Using RAAS Antagonists in COVID-19. News Release. American College of Cardiology; March 17, 2020. Accessed May 6, 2020. https://www.acc.org/latest-in-cardiology/articles/2020/03/17/08/59/hfsa-acc-aha-statement-addresses-concerns-re-using-raas-antagonists-in-covid-19.