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. 2020 Sep 28;9(10):3136.
doi: 10.3390/jcm9103136.

Association of Hypertension with All-Cause Mortality among Hospitalized Patients with COVID-19

Enrique Rodilla  1 , Alberto Saura  1 , Iratxe Jiménez  1 , Andrea Mendizábal  1 , Araceli Pineda-Cantero  2 , Elizabeth Lorenzo-Hernández  2 , Maria Del Pilar Fidalgo-Montero  3 , Joaquín Fernandez López-Cuervo  4 , Ricardo Gil-Sánchez  5 , Elisa Rabadán-Pejenaute  6 , Lucy Abella-Vázquez  7 , Vicente Giner-Galvañ  8 , Marta Nataya Solís-Marquínez  9 , Ramon Boixeda  10 , Andrés de la Peña-Fernández  11 , Francisco Javier Carrasco-Sánchez  12 , Julio González-Moraleja  13 , José David Torres-Peña  14 , María Esther Guisado-Espartero  15 , Joaquín Escobar-Sevilla  16 , Marcos Guzmán-García  17 , María Dolores Martín-Escalante  18 , Ángel Luis Martínez-González  19 , José Manuel Casas-Rojo  20 , Ricardo Gómez-Huelgas  2
Affiliations

Association of Hypertension with All-Cause Mortality among Hospitalized Patients with COVID-19

Enrique Rodilla et al. J Clin Med. .

Abstract

It is unclear to which extent the higher mortality associated with hypertension in the coronavirus disease (COVID-19) is due to its increased prevalence among older patients or to specific mechanisms. Cross-sectional, observational, retrospective multicenter study, analyzing 12226 patients who required hospital admission in 150 Spanish centers included in the nationwide SEMI-COVID-19 Network. We compared the clinical characteristics of survivors versus non-survivors. The mean age of the study population was 67.5 ± 16.1 years, 42.6% were women. Overall, 2630 (21.5%) subjects died. The most common comorbidity was hypertension (50.9%) followed by diabetes (19.1%), and atrial fibrillation (11.2%). Multivariate analysis showed that after adjusting for gender (males, OR: 1.5, p = 0.0001), age tertiles (second and third tertiles, OR: 2.0 and 4.7, p = 0.0001), and Charlson Comorbidity Index scores (second and third tertiles, OR: 4.7 and 8.1, p = 0.0001), hypertension was significantly predictive of all-cause mortality when this comorbidity was treated with angiotensin-converting enzyme inhibitors (ACEIs) (OR: 1.6, p = 0.002) or other than renin-angiotensin-aldosterone blockers (OR: 1.3, p = 0.001) or angiotensin II receptor blockers (ARBs) (OR: 1.2, p = 0.035). The preexisting condition of hypertension had an independent prognostic value for all-cause mortality in patients with COVID-19 who required hospitalization. ARBs showed a lower risk of lethality in hypertensive patients than other antihypertensive drugs.

Keywords: COVID-19; all-cause mortality; angiotensin II receptor blockers (ARBs); angiotensin-converting enzyme inhibitors (ACEIs); hypertension.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Patient inclusion flow chart.
Figure 2
Figure 2
All-cause Mortality according to Hypertension status and previous antihypertensive treatment. * p < 0.0001; + p < 0.001; ⯀ p < 0.01.
Figure 3
Figure 3
Kaplan–Meier curves in patients with/without hypertension according to previous antihypertensive treatment. Log rank p < 0.001.
See this image and copyright information in PMC

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