Cargando…
Association of Antihypertensive Agents with the Risk of In-Hospital Death in Patients with Covid-19
PURPOSE: The role of angiotensin receptor blockers (ARB), angiotensin-converting enzyme inhibitors (ACEi), or other antihypertensive agents in the case of Covid-19 remains controversial. We aimed to investigate the association between antihypertensive agent exposure and in-hospital mortality in pati...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7887412/ https://www.ncbi.nlm.nih.gov/pubmed/33595761 http://dx.doi.org/10.1007/s10557-021-07155-5 |
_version_ | 1783651977096331264 |
---|---|
author | Chouchana, Laurent Beeker, Nathanaël Garcelon, Nicolas Rance, Bastien Paris, Nicolas Salamanca, Elisa Polard, Elisabeth Burgun, Anita Treluyer, Jean-Marc Neuraz, Antoine |
author_facet | Chouchana, Laurent Beeker, Nathanaël Garcelon, Nicolas Rance, Bastien Paris, Nicolas Salamanca, Elisa Polard, Elisabeth Burgun, Anita Treluyer, Jean-Marc Neuraz, Antoine |
author_sort | Chouchana, Laurent |
collection | PubMed |
description | PURPOSE: The role of angiotensin receptor blockers (ARB), angiotensin-converting enzyme inhibitors (ACEi), or other antihypertensive agents in the case of Covid-19 remains controversial. We aimed to investigate the association between antihypertensive agent exposure and in-hospital mortality in patients with Covid-19. METHODS: We performed a retrospective multicenter cohort study on patients hospitalized between February 1 and May 15, 2020. All patients had been followed up for at least 30 days. RESULTS: Of the 8078 hospitalized patients for Covid-19, 3686 (45.6%) had hypertension and were included in the study. In this population, the median age was 75.4 (IQR, 21.5) years and 57.1% were male. Overall in-hospital 30-day mortality was 23.1%. The main antihypertensive pharmacological classes used were calcium channel blockers (CCB) (n=1624, 44.1%), beta-blockers (n=1389, 37.7%), ARB (n=1154, 31.3%), and ACEi (n=998, 27.1%). The risk of mortality was lower in CCB (aOR, 0.83 [0.70–0.99]) and beta-blockers (aOR, 0.80 [0.67–0.95]) users and non-significant in ARB (aOR, 0.88 [0.72–1.06]) and ACEi (aOR, 0.83 [0.68–1.02]) users, compared to non-users. These results remain consistent for patients receiving CCB, beta-blocker, or ARB as monotherapies. CONCLUSION: This large multicenter retrospective of Covid-19 patients with hypertension found a reduced mortality among CCB and beta-blockers users, suggesting a putative protective effect. Our findings did not show any association between the use of renin-angiotensin-aldosterone system inhibitors and the risk of in-hospital death. Although they need to be confirmed in further studies, these results support the continuation of antihypertensive agents in patients with Covid-19, in line with the current guidelines. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10557-021-07155-5. |
format | Online Article Text |
id | pubmed-7887412 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-78874122021-02-17 Association of Antihypertensive Agents with the Risk of In-Hospital Death in Patients with Covid-19 Chouchana, Laurent Beeker, Nathanaël Garcelon, Nicolas Rance, Bastien Paris, Nicolas Salamanca, Elisa Polard, Elisabeth Burgun, Anita Treluyer, Jean-Marc Neuraz, Antoine Cardiovasc Drugs Ther Short Communication PURPOSE: The role of angiotensin receptor blockers (ARB), angiotensin-converting enzyme inhibitors (ACEi), or other antihypertensive agents in the case of Covid-19 remains controversial. We aimed to investigate the association between antihypertensive agent exposure and in-hospital mortality in patients with Covid-19. METHODS: We performed a retrospective multicenter cohort study on patients hospitalized between February 1 and May 15, 2020. All patients had been followed up for at least 30 days. RESULTS: Of the 8078 hospitalized patients for Covid-19, 3686 (45.6%) had hypertension and were included in the study. In this population, the median age was 75.4 (IQR, 21.5) years and 57.1% were male. Overall in-hospital 30-day mortality was 23.1%. The main antihypertensive pharmacological classes used were calcium channel blockers (CCB) (n=1624, 44.1%), beta-blockers (n=1389, 37.7%), ARB (n=1154, 31.3%), and ACEi (n=998, 27.1%). The risk of mortality was lower in CCB (aOR, 0.83 [0.70–0.99]) and beta-blockers (aOR, 0.80 [0.67–0.95]) users and non-significant in ARB (aOR, 0.88 [0.72–1.06]) and ACEi (aOR, 0.83 [0.68–1.02]) users, compared to non-users. These results remain consistent for patients receiving CCB, beta-blocker, or ARB as monotherapies. CONCLUSION: This large multicenter retrospective of Covid-19 patients with hypertension found a reduced mortality among CCB and beta-blockers users, suggesting a putative protective effect. Our findings did not show any association between the use of renin-angiotensin-aldosterone system inhibitors and the risk of in-hospital death. Although they need to be confirmed in further studies, these results support the continuation of antihypertensive agents in patients with Covid-19, in line with the current guidelines. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10557-021-07155-5. Springer US 2021-02-17 2022 /pmc/articles/PMC7887412/ /pubmed/33595761 http://dx.doi.org/10.1007/s10557-021-07155-5 Text en © Springer Science+Business Media, LLC, part of Springer Nature 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Short Communication Chouchana, Laurent Beeker, Nathanaël Garcelon, Nicolas Rance, Bastien Paris, Nicolas Salamanca, Elisa Polard, Elisabeth Burgun, Anita Treluyer, Jean-Marc Neuraz, Antoine Association of Antihypertensive Agents with the Risk of In-Hospital Death in Patients with Covid-19 |
title | Association of Antihypertensive Agents with the Risk of In-Hospital Death in Patients with Covid-19 |
title_full | Association of Antihypertensive Agents with the Risk of In-Hospital Death in Patients with Covid-19 |
title_fullStr | Association of Antihypertensive Agents with the Risk of In-Hospital Death in Patients with Covid-19 |
title_full_unstemmed | Association of Antihypertensive Agents with the Risk of In-Hospital Death in Patients with Covid-19 |
title_short | Association of Antihypertensive Agents with the Risk of In-Hospital Death in Patients with Covid-19 |
title_sort | association of antihypertensive agents with the risk of in-hospital death in patients with covid-19 |
topic | Short Communication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7887412/ https://www.ncbi.nlm.nih.gov/pubmed/33595761 http://dx.doi.org/10.1007/s10557-021-07155-5 |
work_keys_str_mv | AT chouchanalaurent associationofantihypertensiveagentswiththeriskofinhospitaldeathinpatientswithcovid19 AT beekernathanael associationofantihypertensiveagentswiththeriskofinhospitaldeathinpatientswithcovid19 AT garcelonnicolas associationofantihypertensiveagentswiththeriskofinhospitaldeathinpatientswithcovid19 AT rancebastien associationofantihypertensiveagentswiththeriskofinhospitaldeathinpatientswithcovid19 AT parisnicolas associationofantihypertensiveagentswiththeriskofinhospitaldeathinpatientswithcovid19 AT salamancaelisa associationofantihypertensiveagentswiththeriskofinhospitaldeathinpatientswithcovid19 AT polardelisabeth associationofantihypertensiveagentswiththeriskofinhospitaldeathinpatientswithcovid19 AT burgunanita associationofantihypertensiveagentswiththeriskofinhospitaldeathinpatientswithcovid19 AT treluyerjeanmarc associationofantihypertensiveagentswiththeriskofinhospitaldeathinpatientswithcovid19 AT neurazantoine associationofantihypertensiveagentswiththeriskofinhospitaldeathinpatientswithcovid19 AT associationofantihypertensiveagentswiththeriskofinhospitaldeathinpatientswithcovid19 |