Influence of blood pressure control and application of renin‐angiotensin‐aldosterone system inhibitors on the outcomes in COVID‐19 patients with hypertension
| Autor: | Chuan Liu, Fangzhengyuan Yuan, Limin Zhang, Ping Li, Hu Tan, Yuanqi Yang, Jie Yang, Renzheng Chen, Hailin Lv, Chunyan He, Jingbin Ke, Hedong Xiang, Xiaohan Ding, Xubin Gao, Lan Huang, Yang Shen, Ran Cheng |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty China Coronavirus disease 2019 (COVID-19) medicine.medical_treatment Endocrinology Diabetes and Metabolism Angiotensin-Converting Enzyme Inhibitors Blood Pressure 030204 cardiovascular system & hematology Lower risk law.invention Renin-Angiotensin System 03 medical and health sciences Angiotensin Receptor Antagonists 0302 clinical medicine law Internal medicine Renin–angiotensin system Outcome Assessment Health Care medicine Internal Medicine Humans 030212 general & internal medicine Antihypertensive Agents Aged Retrospective Studies Mechanical ventilation Original Paper Septic shock business.industry SARS-CoV-2 COVID-19 Blood Pressure Determination Middle Aged medicine.disease Intensive care unit Original Papers Hospitalization Blood pressure Respiratory failure Case-Control Studies Hypertension Female business Cardiology and Cardiovascular Medicine |
| Zdroj: | The Journal of Clinical Hypertension Journal of Clinical Hypertension (Greenwich, Conn.) |
| ISSN: | 1751-7176 1524-6175 |
| DOI: | 10.1111/jch.14038 |
| Popis: | Hypertension is proved to be associated with severity and mortality in coronavirus disease 2019 (COVID‐19). However, little is known about the effects of pre‐admission and/or in‐hospital antihypertension treatments on clinical outcomes. Thus, this study aimed to investigate the association between in‐hospital blood pressure (BP) control and COVID‐19–related outcomes and to compare the effects of different antihypertension treatments. This study included 2864 COVID‐19 patients and 1628 were hypertensive. Patients were grouped according to their BP during hospitalization and records of medication application. Patients with higher BP showed worse cardiac and renal functions and clinical outcomes. After adjustment, subjects with pre‐admission usage of renin‐angiotensin‐aldosterone system (RAAS) inhibitors (HR = 0.35, 95%CI 0.14‐0.86, P = .022) had a lower risk of adverse clinical outcomes, including death, acute respiratory distress syndrome, respiratory failure, septic shock, mechanical ventilation, and intensive care unit admission. Particularly, hypertension patients receiving RAAS inhibitor treatment either before (HR = 0.35, 95%CI 0.13‐0.97, P = .043) or after (HR = 0.18, 95%CI 0.04‐0.86, P = .031) admission showed a significantly lower risk of adverse clinical outcomes than those receiving application of other antihypertensive medicines. Furthermore, consecutive application of RAAS inhibitors in COVID‐19 patients with hypertension showed better clinical outcomes (HR = 0.10, 95%CI 0.01‐0.83, P = .033) than non‐RAAS inhibitors users. We revealed that COVID‐19 patients with poor BP control during hospitalization had worse clinical outcomes. Compared with other antihypertension medicines, RAAS inhibitors were beneficial for improving clinical outcomes in COVID‐19 patients with hypertension. Our findings provide direct evidence to support the administration of RAAS inhibitors to COVID‐19 patients with hypertension before and after admission. |
| Databáze: | OpenAIRE |
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