High blood pressure Drugs is associated with a critical increased risk of severe COVID-19 courses, which has also been linked to the use of specific blood pressure medication – so-called ACE inhibitors.
These do not lead to an increased risk of fatal illnesses but could counteract them. Research, led by Professor Ulf Landmesser from Charité – Universitätsmedizin Berlin, has found the connections between high blood pressure and COVID-19 – with a definite focus on antihypertensive medicines.
The patient’s immune cells with high blood pressure are pre-activated already, which is massively increased under COVID-19 and could explain the disease’s severe course. The inferences of the study were published in the journal “Nature Biotechnology“.
Increased COVID-19 risk in High BP remains Unclear
“Over a billion humans worldwide suffer from high blood pressure. Of the more than 75 million people worldwide who were infected with SARS-CoV-2, more than 16 million suffered from high blood pressure at the same time,” claims the Berlin Institute of Health (BIH). According to the Institute, high blood pressure people are more prone to infections with the SARS-CoV-2 coronavirus. In their case, COVID-19 diseases are more likely to be severe or even fatal.
However, the causes of the increased COVID-19 risk with high blood pressure have remained unclear so far. Antihypertensive drugs were under suspicion. “The virus uses the ACE2 receptor as a portal of entry into the cells, the formation of which could be influenced by the administration of antihypertensive drugs. We therefore initially feared that patients who received ACE inhibitors or angiotensin receptor blockers might have more ACE2 receptors on their cell surfaces and could become infected more easily as a result,” illustrates Professor Landmesser.
The research team to clarify the suspicion of more than 40 scientists has examined the cells from the air passage of COVID-19 patients on medication for high BP. “We analyzed a total of 114,761 cells from the nasopharynx of 32 COVID-19 patients and 16 non-infected control persons,” illustrated Dr Saskia Trump, a working group leader Irina Lehmann laboratory, BIH professor for environmental epigenetics and lung research.
Immune cell gets noticeably activated beforehand
“We found that the immune cells of the cardiovascular patients showed a noticeable pre-activation even before they were infected with the novel coronavirus,” explained Dr Trump. These patients would have developed a more incredible immune reaction more often after contact with the virus, typically associated with a severe course of COVID-19. “Regardless of the cardiovascular status, enhanced inflammation levels are always a warning signal that the COVID-19 disease will be severe,” told Professor Landmesser.
It became clear that “treatment with ACE inhibitors, but not with angiotensin receptor blockers, could prevent this excessive immune response after infection with the coronavirus,” added Professor Irina Lehmann. ACE inhibitors could even decrease the risk of severe COVID-19.
Hypertension drugs and the viral load.
Besides, it has been shown that antihypertensive drugs could also influence how fast the immune system can decrease the viral load, such as the concentration of the virus in the patient’s body. “Here we saw a clear difference between the various types of treatment for high blood pressure,” told Roland Eils, Director of the BIH Center for Digital Health,
The breakdown of the possible viral load was significantly delayed during treatment with angiotensin II receptor blockers, “that could also contribute to a more severe course of the COVID-19 disease,” reports Eils. But, the delay could not be observed under treatment with ACE inhibitors.
No Enhanced Risk of Infection
“The study gives no evidence that treatment with drugs to lower blood pressure increases the risk of infection for the novel coronavirus,” emphasizes Professor Landmesser. Instead, you can use the medication te, even counteract immune hyperactivation. However, high blood pressure treatment with ACE inhibitors may be advantageous for patients suffering from COVID-19 than therapy with angiotensin II receptor blockers. This now needs to be investigated further.