Hypertension Drugs Are Probably Not Making COVID-19 Worse

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Yesterday I passed along news of a controversy concerning hypertension and COVID-19. The question was simple: does hypertension make COVID-19 more deadly, or is it hypertension drugs that make it more deadly? A couple of new studies out of China suggest that it really is hypertension after all:

One study looked at 362 patients with high blood pressure treated at Central Hospital of Wuhan, the city where the initial outbreak occurred. It found no difference between those on the drugs and those not in terms of the severity of the disease and whether a patient survived or died, researchers from the hospital report online April 23 in JAMA Cardiology. The other study followed 1,128 COVID-19 patients with hypertension from nine hospitals in Hubei Provence, where Wuhan is located. It found that the mortality rate was lower for the 188 on the drugs, an international research team reports online April 17 in Circulation Research.

The new studies provide reassurance that the drugs “are not associated with harm in patients with COVID-19, as some had suspected,” says cardiologist Scott Solomon of Brigham and Women’s Hospital and Harvard Medical School in Boston. But without randomized controlled trials, in which patients are randomly chosen to take a drug or a placebo, “it will be very difficult to get at the truth” of exactly what impact the drugs have, he says.

Sure, we would all like a bunch of randomized controlled trials, but we’re not going to get them in the middle of a pandemic. Observational studies like these are the best we’re going to do, and properly conducted they should provide pretty reliable results. My only hesitation here is that a lot of studies and projections based on the Wuhan outbreak have later turned out to be unique to Wuhan. I can’t think of any reason this should be true for hypertension drugs, but COVID-19 is a weird disease. You never know.

For now, though, this is the best we’ve got. Talk to your doctor, of course, but it looks like hypertension drugs are probably in the clear.

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