scholarly journals Differential effects of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers on COVID-19

2020 ◽  
Author(s):  
lianjiu su ◽  
jiahao zhang ◽  
nanhui jiang ◽  
jie yang ◽  
li he ◽  
...  
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Cox Regression ◽  
Angiotensin Receptor Blockers ◽  
Case Series ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Severe Illness ◽  
Converting Enzyme ◽  
Cox Regression Analysis ◽  
Receptor Blockers

Abstract BackgroundThe effect of angiotensin-converting enzyme inhibitor/angiotensin receptor blockers (ACEI/ARB) on the COVID-19 remains controversial from clinic evidence. MethodsThis is a retrospective, two-center case series of 198 consecutive COVID-19 patients with a history of hypertension. ResultsAmong 198 patients, 58 (29.3%) and 16 (8.1%) were on were on ARB and ACEI, respectively. Patients who were on ARB or ACEI/ARB had a significantly lower rate of severe illness and ARDS when compared with patients treated with ACEI alone or not receiving and RAAS blocker (P＜0.05). The Kaplan-Meier survival curve showed that patients with ARB in their antihypertensive regimen had a trend towards a higher survival rate when compared with individuals without ARB (adjusted hazard ratio, 0.27; 95% CI, 0.07-1.02; P = 0.054). The Cox-regression analysis to compared ACEI vs. ARB groups showed a significantly lower mortality rate in the ARB group (adjusted hazard ratio, 0.03; 95% CI, 0.00-0.58; P = 0.02). ConclusionsUsing of ARB was associated with a reduced rate of severe illness and ARDS, indicating their potential protective impact in COVID-19.

scholarly journals Análise da Revisão Cochrane: Inibidores da Enzima de Conversão da Angiotensina Versus Antagonistas do Receptor da Angiotensina como Prevenção Cardiovascular na Hipertensão Essencial. Cochrane Database Syst Rev. 2014,8: CD009096.

2015 ◽  
Vol 28 (3) ◽  
pp. 283 ◽  
Author(s):  
Luís Nogueira-Silva ◽  
João A. Fonseca
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Cardiovascular Events ◽  
Enzyme Inhibitors ◽  
Angiotensin Receptor Blockers ◽  
Total Mortality ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Angiotensin Receptor ◽  
Converting Enzyme Inhibitors ◽  
Receptor Blockers

Angiotensin converting enzyme inhibitors and angiotensin receptor blockers are first line drugs in the treatment of hypertension. The aim of this review was to assess if there are differences between these drug classes regarding the prevention of total mortality, occurrence of cardiovascular events and of adverse effects. A systematic review and metanalysis was performed, searching for studies that compare angiotensin converting enzyme inhibitors and angiotensin receptor blockers face-to-face, in several databases until July 2014. The study selection and data extraction were performed by 2 independent researchers. Nine studies were included, with a total of 10 963 participants, 9 398 of which participated in the same study and had high cardiovascular risk. No differences were observed regarding total mortality, cardiovascular mortality or total cardiovascular events. A slightly smaller risk was observed with angiotensin receptor blockers regarding withdrawal due to adverse effects (55 people were needed to be treated with angiotensin receptor blockers for 4.1 years to avoid one withdrawal due to adverse effect), mainly due to the occurrence of dry cough with angiotensin converting enzyme inhibitors. Thus, no differences were observed between angiotensin converting enzyme inhibitors and angiotensin receptor blockers in the prevention of total mortality and cardiovascular events, and angiotensin receptor blockers were better tolerated. Given the large proportion of participants with a high cardiovascular risk, the generalization of these results to other populations is limited.

Sign in / Sign up

Export Citation Format

Share Document