Since there are many unknowns about the novel coronavirus and how it affects the human body, cardiologists have voiced important concerns surrounding high blood pressure medication. Their calls for urgent research have been met by scientists at the New York University (NYU) Grossman School of Medicine, who thankfully found that high blood pressure medication doesn’t seem to increase the risk of infection or of developing severe forms of COVID-19.
High blood pressure medication is surprisingly safe
The researchers led by Harmony Reynolds, Associate Director at the Cardiovascular Clinical Research Center at NYU, studied the medical history of 12,594 COVID-19 positive patients. Specifically, the researchers analyzed COVID-19 outcomes for those taking medication for high blood pressure.
There was no link between treatment with four common drug classes for high blood pressure — angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), beta blockers, or calcium channel blockers — and the likelihood of becoming infected with the coronavirus.
What’s more, there was no additional risk of developing more severe forms of COVID-19 that might require hospitalization in an intensive care unit or the use of mechanical ventilators. The findings appeared in the New England Journal of Medicine.
“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 Reynold.
“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.”
The drugs included in the study regulate blood pressure by acting upon the renin-angiotensin-aldosterone hormonal system. One important component of this system is angiotensin II, a signaling protein that narrows blood vessels, thereby increasing blood pressure.
Levels of angiotensin II are controlled by the angiotensin-converting enzyme (ACE), which is also the target of many drugs for hypertension.
One version of ACE, ACE2, is abundantly present in the outer membrane of lung cells. The general consensus is that the novel coronavirus attaches itself to ACE2 receptors in lung cells using its ‘spike’ protein.
The use of ACE inhibitors boosts the expression and abundance of ACE2 receptors, and thus potentially increases the number of portals for SARS-CoV-2 to enter cells throughout the body.
This is why many cardiologists were concerned about the impact that medication designed to inhibit ACE might have on the prognosis of COVID-19 patients.
Fortunately, this doesn’t seem to be the case. In fact, ACE inhibitors might actually reduce lung injury.
Earlier last week, researchers at the University of California San Diego School of Medicine launched a clinical trial to investigate whether a drug approved for treating high blood pressure, heart failure, and diabetic kidney disease might also reduce the severity of COVID-19 infections. The trial will include participants from various sites across the United States, including New York, New Jersey, California, Massachusetts, Washington, Texas, and Illinois.