Blood Pressure Meds Can Affect COVID-19 Care

Overall, having a history of high blood pressure increased a person’s risk of kidney injury about fivefold, the Italian study found.

A third study digging deeper into this phenomenon found that common blood pressure meds were associated with an increased risk of death among COVID-19 patients.

The researchers tracked 172 people hospitalized for COVID-19 at the University of Miami/JFK Medical Center in Atlantis, Fla. The investigators found that 33% of people taking either angiotensin-converting enzyme inhibitors (ACE inhibitors) or angiotensin receptor blockers (ARBs) died in the hospital, compared with 13% of people not taking either drug.

COVID-19 patients were also more likely to land in the intensive care unit if they were taking one of these blood pressure meds — 28% of those with a prescription versus 13% not taking either drug.

Dr. Vivek Bhalla, director of the Stanford Hypertension Center in California, said it’s not very likely that these blood pressure medications in themselves are harmful to COVID-19 patients.

Instead, “the medicines are markers of the underlying disease for which they were prescribed,” Bhalla said.

“For example, patients with [high blood pressure] or diabetes have worse outcomes with COVID-19, and these are the same patients that are commonly prescribed ACE inhibitors and ARBs,” Bhalla said. “Other blood pressure medications may be associated with severity of COVID-19 if one considers that low blood pressure, perhaps due to use of these medications, may be associated with higher mortality.”

If they contract COVID-19, people with high blood pressure should talk with their doctor for guidance on taking their medication, Bhalla said.

“In general, current data suggest that the medications themselves are not harmful, and the consequences of stopping these medications are well-documented,” Bhalla said. “However, if folks feel that they are not eating as much as they normally do, or have symptoms that lead to dehydration, such as vomiting, diarrhea, bleeding, or excessive sweating, then it is very reasonable to temporarily hold their higher blood pressure medication until their symptoms resolve.”

Doctors should assess COVID-19 patients and not keep them on blood pressure meds if their blood pressure drops or they have other troubling symptoms, Bhalla said.