Hypertension among COVID-19 patients associated with poor prognosis, finds study

A new investigation revealed that in-hospital mortality and adverse outcomes in COVID-19 are due to hypertension, but angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) do not increase the same. The study was published in the 'Journal of Hypertension.' 

There are controversial reports on whether hypertension or ACEIs/ARBs causes in-hospital mortality leading to poorer outcomes in COVID 19 infection. Hence researchers conducted a systematic review and meta-analysis to summarize the same. Using the MeSH terms all existing studies were retrieved by MEDLINE via PubMed, CENTRAL, and Embase until 30 April 2021. The pooled adjusted odds ratio (AOR) with a 95% confidence interval (CI) was calculated using a fixed or random effect model. The interaction effect of hypertension and age on in-hospital mortality was performed using the Interactive analysis. 

Results:

• In total, 86 articles with 1,87,75,387 COVID-19 patients from 18 countries were included in this study.
• The pooled analysis showed that when compared with those without hypertension, the COVID-19 patients with hypertension had increased risks of in-hospital mortality and other adverse outcomes, with an AOR (95% CI) of 1.36 and 1.32, respectively.
• In countries with more than three independent studies the results were mostly repeated.
• younger and older COVID-19 patients with hypertension showed more evident in-hospital mortality than 60–69-year-old patients.
• ACEI/ARBs did not significantly affect the mortality and adverse outcomes of COVID-19 patients, compared with those receiving other antihypertensive treatment 

Thus, it was concluded from the study that an increased risk of in-hospital mortality and adverse outcomes in COVID-19 was significantly associated with hypertension, and it followed a U-shaped curve. It was also found that the increase was not seen in COVID-19 patients under ACEI/ARB treatments. 

To read the full article, click here: 10.1097/HJH.0000000000003266 

Kabia AU, Li P, Jin Z, et al. The effects of hypertension on the prognosis of coronavirus disease 2019: a systematic review and meta-analysis on the interactions with age and antihypertensive treatment [published online ahead of print, 2022 Aug 9]. J Hypertens. 2022;10.1097/HJH.0000000000003266.