Researchers: Blood pressure drugs not a risk

Drugs that are widely prescribed to treat high blood pressure do not make patients more susceptible to coronavirus infection, or to severe illness if they do become infected, researchers reported Friday.

Their findings are good news for millions of people who take blood pressure drugs that belong to two classes: ACE inhibitors, which include lisinopril, captopril and other drugs with generic names ending in –pril; and ARBs, which include losartan, valsartan and other generic drugs ending in –sartan. Brand names for ACE inhibitors include Zestril and Prinivil; for ARBs, Cozaar and Atacand.

Since the epidemic began, conflicting theories have circulated about whether those drugs could make the disease better or worse, or have any effect at all.

The new research was published Friday by the New England Journal of Medicine, and similar findings from China were published last week in JAMA Cardiology.

The U.S. study also found no risk linked to three other classes of commonly used blood pressure drugs — beta blockers, calciumchannel blockers and thiazide diuretics.

Both studies were based on reviewing patients’ records, which does not provide evidence as strong as the results of controlled clinical trials, in which patients are picked at random to take one treatment or another.

Concerns arose about the drugs early in the epidemic when reports from China indicated that people with hypertension seemed to fare poorly, and it seemed logical to investigate if the cause was the condition itself or if blood pressure drugs were somehow making patients more vulnerable.

In addition, studies in animals had shown that ARBs and ACE inhibitors could increase the levels in some tissue of a protein called ACE2, which happens to be the substance that the virus grabs onto as it invades cells. In theory, higher levels of that protein in the lungs might help the virus attack by acting as extra handholds, some scientists have warned. But it is not known whether the drugs actually raise ACE2 in human lungs.

Confounding the matter was evidence from animal studies that suggested the opposite effect: The drugs might quell inflammation in the lungs and lower the risk of severe disease in coronavirus patients. A controlled trial is about to begin to find out if ACE inhibitors can help COVID-19 patients, the University of California San Diego School of Medicine announced Thursday.