HÖGT Blodtryck är INte en riskfaktor?

Coronalinjen

Vid det här laget har du säkert läst att högt blodtryck är en riskfaktor för Covid-19. Det har då antagits att blodtrycksmediciner med ACG hämmare ger uttryck för ökat antal ACG receptorer för viruset att fästa på. I en nylig studie visar det sig att blodtrycksmedicinerna istället sänker risken för att dö orsakad av Corona. Artikeln är inte granskad (peer reviewed) av oberoende forskare och en ganska liten studie som inte visar på statistisk säkerhet och har fått relativt bred kritik från framstående forskare inom området.

4 april -2020 - Angiotensin II Receptor Blockers and Angiotensin-Converting Enzyme Inhibitors Usage is Associated with Improved Inflammatory Status and Clinical Outcomes in COVID-19 Patients With Hypertension

Källa: MedRxiv

Abstract

Background

With the capability of inducing elevated expression of ACE2, the cellular receptor for SARS-CoV-2, angiotensin II receptor blockers or angiotensin-converting enzyme inhibitors (ARBs/ACEIs) treatment may have a controversial role in both facilitating virus infection and reducing pathogenic inflammation.

We aimed to evaluate the correlation of ARBs/ACEIs usage with the pathogenesis of COVID-19 in a retrospective, single-center study.

Patients and methods

126 COVID-19 patients with preexisting hypertension at Hubei Provincial Hospital of Traditional Chinese Medicine (HPHTCM) in Wuhan from January 5 to February 22, 2020 were retrospectively allocated to ARBs/ACEIs group (n=43) and non-ARBs/ACEIs group (n=83) according to their antihypertensive medication. 125 age- and sex-matched COVID-19 patients without hypertension were randomly selected as non-hypertension controls. In addition, the medication history of 1942 hypertension patients that were admitted to HPHTCM from November 1 to December 31, 2019 before COVID-19 outbreak were also reviewed for external comparison. Epidemiological, demographic, clinical and laboratory data were collected, analyzed and compared between these groups.

The frequency of ARBs/ACEIs usage in hypertension patients with or without COVID-19 were comparable. Among COVID-19 patients with hypertension, those received either ARBs/ACEIs or non-ARBs/ACEIs had comparable blood pressure.

Results

However, ARBs/ACEIs group had significantly lower concentrations of CRP (p=0.049) and procalcitonin (PCT, p=0.008). Furthermore, much lower proportion of critical patients (9.3% vs 22.9%; p=0.061), and a lower death rate (4.7% vs 13.3%; p=0.216) were observed in ARBs/ACEIs group than non-ARBs/ACEIs group, although these differences failed to reach statistical significance.

Conclusion

Our findings thus support the use of ARBs/ACEIs in COVID-19 patients with preexisting hypertension.