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High blood pressure medications may lower risk of dying from COVID-19

Recent studies indicate that people with cardiovascular disease, including hypertension, have an increased risk of dying from COVID-19. However, a study by Penn State College of Medicine researchers suggests that COVID-19 patients who take medications to control high blood pressure may have better outcomes. The findings, published in BMJ Open Heart, show that patients with prior use of renin-angiotensin-aldosterone system (RAAS) inhibitors may have a lower risk of dying from COVID-19.

The body’s RAAS produces hormones that regulate blood pressure and support kidney function. Prior research found that SARS-CoV-2, the strain responsible for the recent coronavirus outbreak, interfaces with the RAAS through angiotensin-converting enzyme 2 (ACE2). Many people take RAAS-inhibitors to treat conditions including high blood pressure and chronic kidney disease. ACE-inhibitors (ACEi) and angiotensin-II blockers (ARBs), which are commonly used in patients with hypertension, diabetes, chronic kidney disease and congested heart failure, may upregulate ACE2 expression. Because SARS-CoV-2 binds to the ACE2, which serves as the virus’ point of entry researchers hypothesize that RAAS-inhibitors may increase the risk of severe SARS-CoV-2 infection.

The College of Medicine research team studied more than 70,000 patients worldwide who were hospitalized for COVID-19 and conducted a systematic review and meta-analysis of reports published by MEDLINE, Scopus, OVID, the Cochrane Library and Medrxiv from January through Sept. 1. The researchers found that among patients with hypertension, those who reported prior use of RAAS inhibitors had a 35% lower risk of dying from COVID-19. According to the researchers, these results suggest that RAAS-inhibitors may yield a protective effect in COVID-19 patients with high blood pressure.

“There has been conflicting evidence of whether RAAS-inhibitors were associated with increased risk of death from COVID-19 in hospitalized patients,” said Anna Ssentongo, Doctor of Public Health student and co-author of the study. “We hope these findings help the CDC guide treatment for patients with hypertension during this pandemic.”

The researchers said the study indicates that patients taking RAAS-inhibitors to manage chronic conditions may continue to do so under the guidance of their health care providers.

“This is the first study of its kind that showed that patients should continue to take RAAS-inhibitors even when they are infected with COVID-19,” said co-author Dr. John Oh, a surgeon at Penn State Health Milton S. Hershey Medical Center. “This research will go a long way toward helping us understand this new disease.”

Emily Heilbrunn, Vernon Chinchilli, Duanping Liao, Paddy Ssentongo, Alain Lekoubou of Penn State College of Medicine and Ping Du of Takeda Pharmaceutical Company also contributed to this study.

Read the full study


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