ΑCE inhibitors, ARBs and Coronavirus

There have been concerns reported in the news recently about adverse effects of certain medication used to treat blood pressure and renal problems, raising the risk of infection from SARS-Cov-2 (the new coronavirus) and increasing the severity of the clinical symptoms.

What is the medication?

This relates to a specific type of medication called Angiotensin-Converting Enzyme inhibitors (ACE) inhibitors and Angiotensin Receptor Blockers (ARBs).

ACE inhibitors include ramipril, lisinopril, enalapril. ARBs include losartan, candersartan and valsartan.

What is the current advice?

The Council on Hypertension of the European Society of Cardiology wish to highlight the lack of any evidence supporting harmful effect of ACE-I and ARB in the context of the pandemic COVID-19 outbreak. They strongly recommend that physicians and patients should continue treatment with their usual anti-hypertensive therapy because there is no clinical or scientific evidence to suggest that treatment with ACEi or ARBs should be discontinued because of the Covid-19 infection. [1]

This is supported by other Professional Societies, who have released similar supporting statements, such as the International Society of Hypertension [2] and the Renal Association UK who advise people taking these medications to continue to take them.[3]

What does this mean for me?

The situation is always changing with new research and evidence coming to light. Advice may change in the future. However current advice from 17th March 2020 is for patients to continue with their usual ACE inhibitors or ARBs. Stopping the medication can lead to worsening of pre-existing conditions and is not recommended. If you have any concerns, please discuss with your Personal Doctor.

References

[1] Position Statement of the ESC Council on Hypertension on ACE-Inhibitors and Angiotensin Receptor Blockers.13 Mar 2020. Prof. Giovanni de Simone, Chair, ESC Council on Hypertension, On behalf of the Nucleus Members

[2] A statement from the International Society of Hypertension on COVID-19, 16th March 2020

[3] The Renal Association, UK position statement for patients: novel corona virus infection and the use of blood pressure medications, 15th March 2020

[4] Sparks MA, Hiremath S et al. “The Coronavirus Conundrum: ACE2 and Hypertension Edition” NephJC http://www.nephjc.com/news/covidace2 accessed March 17, 2020

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