Association of Antihypertensive Agents with the Risk of In-Hospital Death in Patients with Covid-19 - Archive ouverte HAL Access content directly
Journal Articles Cardiovascular Drugs and Therapy Year : 2021

Association of Antihypertensive Agents with the Risk of In-Hospital Death in Patients with Covid-19

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Abstract

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.

Dates and versions

hal-03476800 , version 1 (13-12-2021)

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Laurent Chouchana, Nathanaël Beeker, Nicolas Garcelon, Bastien Rance, Nicolas Paris, et al.. Association of Antihypertensive Agents with the Risk of In-Hospital Death in Patients with Covid-19. Cardiovascular Drugs and Therapy, 2021, ⟨10.1007/s10557-021-07155-5⟩. ⟨hal-03476800⟩
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