Renin-angiotensin system blocker and the COVID-19 aggravation in patients with hypertension, diabetes, renal failure, Cerebro-cardiovascular disease, or pulmonary disease: Report by the COVID-19 Registry Japan

Yoshihara, Fumiki; Ohtsu, Hiroshi; Nakai, Michikazu; Tsuzuki, Shinya; Hayakawa, Kayoko; Terada, Mari; Matsunaga, Nobuaki; Yasuda, Satoshi; Ogawa, Hisao; Ohmagari, Norio

doi:10.1016/j.jjcc.2022.04.001

Cited by 3 publications

(2 citation statements)

References 41 publications

(57 reference statements)

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“…The data that advocate a beneficial role of ACEI and ARAII are based on the existence of lower levels of cytokines, decreasing inflammatory levels and IL6 expression in patients with severe COVID-19, and lower associated mortality data [ 48 , 49 , 50 ], as well as a possible protective factors for severe cases [ 51 , 52 ]. However, this has not been demonstrated in clinical practice [ 53 ]. A recent clinical trial has not been able to show improvement in lung function in patients with losartan (ARAII) [ 54 ] or provide statistically significant data that may have a clinical impact [ 55 ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 and the Use of Angiotensin II Receptor Blockers in Older Chronic Hypertensive Patients: Systematic Review and Meta-Analysis

Quesada-Caballero,

Carmona-García,

Chami-Peña

et al. 2023

Medicina

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Angiotensin II-converting enzyme inhibitors (ACEIs) and selective angiotensin II receptor antagonists (ARAIIs) are widely used antihypertensive agents. Their use has generated controversy due to their possible influence on the health status of chronic patients infected with COVID-19. The objective of this work is to analyze the influence of COVID-19 on chronic hypertensive patients treated with ACEI and ARAII inhibitors. A systematic review and meta-analysis in the databases Pubmed, Pro-Quest and Scopus were carried out. The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search equation descriptors were obtained from the Medical Subject Headings (MeSH) thesaurus. The search equation was: “Older AND hypertension AND (COVID-19 OR coronavirus) AND primary care” and its equivalent in Spanish. Nineteen articles were obtained, with n = 10,806,159 subjects. Several studies describe the COVID-19 association with ACEI or ARAII treatment in hypertension patients as a protective factor, some as a risk factor, and others without a risk association. In the case of ACEI vs. ARAII, the risk described for the former has an odds ratio (OR) of 0.55, and for ARAII, an OR of 0.59. Some authors talk about mortality associated with COVID-19 and ACEI with a half ratio (HR) of 0.97, and also associated ARAIIs with an HR of 0.98. It is recommended to maintain the use of the renin–angiotensin–aldosterone axis in the context of the COVID-19 disease.

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Section: Discussionmentioning

confidence: 99%

COVID-19 and the Use of Angiotensin II Receptor Blockers in Older Chronic Hypertensive Patients: Systematic Review and Meta-Analysis

Quesada-Caballero,

Carmona-García,

Chami-Peña

et al. 2023

Medicina

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“…Using the data from COVIREGI-JP as of November 2020, the study by Yoshihara et al analyzed the factors associated with the increased risk of primary outcomes, which were in-hospital death, ventilator support, extracorporeal membrane oxygen support, and ICU admission. Although the study found that aging, male sex, COPD, severe renal impairment, and diabetes mellitus were associated with the increased primary outcomes, no associations were found with the use of ACEIs and ARBs [58]. In addition, several recent metaanalysis of observational studies reported the safety or the potential benefit of RAS inhibitors in patients with hypertension [59].…”

Section: Current Evidence On Ace Inhibitors and Arbs In Patients With...mentioning

confidence: 92%

COVID-19 pandemic and hypertension: an updated report from the Japanese Society of Hypertension project team on COVID-19

et al. 2022

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The number of reported cases with coronavirus disease 2019 (COVID-19) has exceeded 620 million worldwide, still having a profound impact on people's health and daily lives since its occurrence and outbreak in December 2019. From the early phase of the COVID-19 pandemic, there has been a concern that the rapid spread of this communicable disease can negatively influence non-communicable diseases. Accumulating data indicate that the restriction on the access to medical care, psychological distress, and life-style changes triggered by the pandemic have indeed affected blood pressure control in hypertensive patients. Since our previous report in 2020 that summarized the findings of the literature related to COVID-19 and hypertension, there has been a considerable progress in our understanding of the association between these two disorders; nonetheless, there are remaining challenges and emerging questions in the field. In this article, we aim to summarize the latest information on the impact of the pandemic on blood pressure control, the use of the renin-angiotensin system inhibitors in patients with COVID-19, and the blood pressure changes as one of the possible post-acute sequelae of COVID-19 (also known as long COVID). We also summarize the evidence of telemedicine and COVID-19 vaccination in hypertensive subjects, based on data available as of June 2022.

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Relationship between 2nd-generation angiotensin receptor blockers and the risk of hypotension in COVID-19 patients admitted to hospital

Yoshihara,

Matsuzawa,

Nakatsuka

et al. 2024

Hypertens Res

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Renin-angiotensin system blocker and the COVID-19 aggravation in patients with hypertension, diabetes, renal failure, Cerebro-cardiovascular disease, or pulmonary disease: Report by the COVID-19 Registry Japan

Cited by 3 publications

References 41 publications

COVID-19 and the Use of Angiotensin II Receptor Blockers in Older Chronic Hypertensive Patients: Systematic Review and Meta-Analysis

COVID-19 and the Use of Angiotensin II Receptor Blockers in Older Chronic Hypertensive Patients: Systematic Review and Meta-Analysis

COVID-19 pandemic and hypertension: an updated report from the Japanese Society of Hypertension project team on COVID-19

Relationship between 2nd-generation angiotensin receptor blockers and the risk of hypotension in COVID-19 patients admitted to hospital

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