New questions about how blood pressure could affect COVID-19 arise as the pandemic continues around the world. It is known that the virus affects everyone differently, leaving some with mild symptoms and others in critical condition. But as more information comes to light about those individuals, one clue has stood out. A disproportionate number of patients with COVID-19 have high blood pressure.
Researchers have theories as to why the condition makes people more vulnerable, but it has also sparked a fierce debate over the impact that the blood pressure drugs have on the virus. It is agreed that the blood pressure drugs affect the same pathways that the novel coronavirus takes to enter the lungs and heart. However, there are differing opinions on whether those drugs open the door to the virus or protect against it.
The evidence so far has shown that the drugs may increase the presence of an enzyme, ACE2, which produces hormones that lower blood pressure by widening blood vessels. That is normally a good thing. But the coronavirus also targets ACE2 and has developed spikes that can latch on to the enzyme and penetrate cells. This means if there are more enzymes, there are more targets for the virus, potentially increasing the chance of infection or making it more severe.
Research has shown that 72% of all hospitalized COVID-19 patients 65 or older had hypertension and were on ACE inhibitors. In a recent interview with a medical journal, Anthony Fauci, the U.S. government’s top infectious disease expert spoke about the connection between these drugs and COVID-19. He cited a report showing high rates of hypertension among COVID-19 patients who died in Italy and suggested: “the medicines, rather than the underlying condition, may act as an accelerant for the virus.”
Unfortunately, because there is such limited knowledge about the virus and how it affects the body, questions concerning how the virus uses the pathways to the heart and lungs, and the role of medicines, remains unanswered.
“There are millions of Americans that take an ACE inhibitor or AR daily,” said Dr. Caleb Alexander, co-director of the Johns Hopkins Center for Drug Safety and Effectiveness in Baltimore. “This is one of the most important clinical questions.”
Do Drugs Hurt or Help?
The lack of information on how the blood pressure drugs impact COVID-19 patients has sparked many editorials on medical journal websites and unreviewed, pre-publication study drafts. This has left many patients agonizing over whether their medications will hurt them more than help them. But health care professionals are reminding people that dropping the medicine could present more problems in dealing with high blood pressure.
It is estimated that over 100 million U.S. residents suffer from high blood pressure, which can increase the risk of heart disease, stroke, and kidney failure. According to the CDC, about four-fifths of patients with congestive heart failure, diabetes, or kidney disease take the drugs to help control high blood pressure. These are the patients that are at an increased risk for COVID-19.
The National Institutes of Health in the United States has put out a call seeking proposals for studies into the issue.
Until more research is done on the subject, doctors urge patients to keep taking drugs they have been prescribed. Never stop taking a prescription drug unless under doctor supervision.