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Observational Study
. 2020 Aug;22(8):1379-1388.
doi: 10.1111/jch.13948. Epub 2020 Jul 25.

Use of distinct anti-hypertensive drugs and risk for COVID-19 among hypertensive people: A population-based cohort study in Southern Catalonia, Spain

Angel Vila-Corcoles  1   2 , Eva Satue-Gracia  1   2 , Olga Ochoa-Gondar  1   2 , Cristina Torrente-Fraga  3 , Frederic Gomez-Bertomeu  4 , Angel Vila-Rovira  2 , Imma Hospital-Guardiola  1 , Cinta de Diego-Cabanes  1 , Ferran Bejarano-Romero  5 , Dolors Rovira-Veciana  6 , Josep Basora-Gallisa  7
Affiliations
Observational Study

Use of distinct anti-hypertensive drugs and risk for COVID-19 among hypertensive people: A population-based cohort study in Southern Catalonia, Spain

Angel Vila-Corcoles et al. J Clin Hypertens (Greenwich). 2020 Aug.

Abstract

The use of some anti-hypertensive drugs in the current COVID-19 pandemic has become controversial. This study investigated possible relationships between anti-hypertensive medications use and COVID-19 infection risk in the ambulatory hypertensive population. This is a population-based retrospective cohort study involving 34 936 hypertensive adults >50 years in Tarragona (Southern Catalonia, Spain) who were retrospectively followed through pandemic period (from 01/03/2020 to 30/04/2020). Two data sets including demographic/clinical characteristics (comorbidities and cardiovascular medications use) and laboratory PCR codes for COVID-19 were linked to construct an anonymized research database. Cox regression was used to calculate multivariable hazard ratios (HRs) and estimate the risk of suffering COVID-19 infection. Across study period, 205 PCR-confirmed COVID-19 cases were observed, which means an overall incidence of 586.8 cases per 100 000 persons-period. In multivariable analyses, only age (HR: 1.03; 95% CI: 1.02-1.05; P < .001) and nursing home residence (HR: 19.60; 95% CI: 13.80-27.84; P < .001) appeared significantly associated with increased risk of COVID-19. Considering anti-hypertensive drugs, receiving diuretics (HR: 1.22; 95% CI: 0.90-1.67; P = .205), calcium channel blockers (HR: 1.29; 95%CI: 0.91-1.82; P = .148), beta-blockers (HR: 0.97; 95% CI: 0.68-1.37; P = .844), and angiotensin-converting enzyme inhibitors (HR: 0.83; 95% CI: 0.61-1.13; P = .238) did not significantly alter the risk of PCR-confirmed COVID-19, whereas receiving angiotensin II receptor blockers was associated with an almost statistically significant reduction risk (HR: 0.67; 95% CI: 0.44-1.01; P = .054). In conclusion, our data support that receiving renin-angiotensin-aldosterone system inhibitors does not predispose for suffering COVID-19 infection in ambulatory hypertensive people. Conversely, receiving angiotensin II receptor blockers could be related with a reduced risk.

Keywords: COVID-19; SARS-COV-2; angiotensin II receptor blockers; angiotensin-converting enzyme inhibitors; anti-hypertensive medication; hypertension.

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Conflict of interest statement

All authors declared that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Kaplan‐Meier curves (survival free of COVID‐19 infection) comparing patients taking vs not taking angiotensin II receptor blockers (ARBs) treatment
See this image and copyright information in PMC

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