Coronavirus and hypertension drugs, there is no need to stop therapies

Coronavirus, it is necessary to continue with chronic therapies for hypertension or heart disease. Experts clarify

Don't stop taking medications to keep your blood pressure under control. If you have any doubts, ask the doctor. It is the advice that comes from the scientific community after the publication of some research that, in an attempt to explain why Sars2-CoV-2019 infection could have a higher lethality in heart disease and hypertensive patients.

But the main scientific societies have taken the field to clear the field of misunderstandings and issue a clear warning: we must not stop the anti-hypertension therapies that keep pressure under control. In case of infection, the doctor will eventually suspend the treatment.

The position of the experts

"There is no evidence associating hypertension with COVID-19 disease: if hypertension were a predisposing factor for coronavirus infection, there should be more hypertensive patients among COVID-19 patients than observed in the general population. To date, there is no evidence that people with hypertension are over-represented among those severely infected with COVID-19. Therefore, patients should continue to follow antihypertensive therapies as recommended by international guidelines. "

The position of the Italian Society of High Blood Pressure / Italian League against High Blood Pressure (SIIA) is clear and firm, in relation to recent news on an alleged relationship between hypertension and COVID-19 as well as between taking anti-hypertensive therapy (ACE inhibitors and angiotensin-II receptor antagonists) and risk of coronavirus infection, which are helping to destabilize the certainties acquired from years of study and experimental evidence. The Italian Society of High Blood Pressure remembers it, reiterating a message that the Italian Society of Cardiology (SIC) has already launched in recent days.

The SIC has issued a document, available on the website, which stresses that it is absolutely necessary to continue with the chronic therapies for hypertension or heart disease prescribed by specialists as before the coronavirus emergency.

"At present there are no studies in humans that demonstrate a beneficial or negative effect of ACE inhibitors or sartans in patients with COVID-19", explains Ciro Indolfi, President of the Italian Society of Cardiology.

“So we have no information that can recommend or advise against these therapies in patients with coronavirus. Furthermore, in patients not affected by COVID-19 these drugs, which have shown extraordinary efficacy in reducing morbidity and mortality, can be used with confidence ", underlines the expert.

Because there is no need to calm down

A few days ago, in fact, research published in Nature Reviews Cardiology had shown a possible link between coronavirus infection and a special enzyme (ACE2, or angiotensin 2 conversion enzyme) that could play a role both in cardiovascular system, coming into play both in the genesis of hypertension and diabetes, and in the immune system. ACE2 would act as a functional receptor for coronaviruses.

However, the study only has the sense of explaining the possible damage to the heart linked to the virus, but it should not suggest a role of drugs in this sense. For this reason, ACE inhibitors and angiotensin II receptor antagonist drugs (also known as sartans) can be used in patients without COVID-19 without any risk.

In patients with coronavirus, no effects have been documented that demonstrate a greater risk of complications if these drugs are used.

“We reiterate that, in stable hypertensive patients with COVID-19 infections or at risk of COVID-19 infections, treatment with these drugs CEI and ARB must be carried out according to the recommendations contained in the guidelines of the European Society of Cardiology (ESC) and of the Company European Hypertension (ESH) of 2018 – underlines Guiido Grassi, President of SIIA. Even the Italian Medicines Agency (AIFA) has recommended not to modify the current anti-hypertensive therapy in well-controlled hypertensive patients, because exposing fragile patients to potential new side effects or an increased risk of cardiovascular adverse events does not appear justified ". The same must happen for those who are being treated with drugs of this type for heart failure.

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