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Why do people with high blood pressure seem to do worse with COVID-19?

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It’s true. People with high blood pressure, heart disease or heart failure do seem to get sicker with COVID-19 compared to healthy people. While pneumonia is the most common complication of the virus, it can also damage the cardiovascular system.

This has been in the news because of concerns about 2 common classes of blood pressure medicines, angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs). On March 17th the American College of Cardiology, the American Heart Association and the Heart Failure Society of America responded with a statement that people taking ACE or ARBs should continue taking their medications as prescribed by their doctors.

For background, the COVID-19 virus enters human cells through a receptor called angiotensin converting enzyme 2 (ACE2). In theory, ACE or ARB medications could impact the ACE2 in people sick with COVID-19. But at this point, we don’t have the data to know if the impact is good, bad or neutral. Hopefully, over the next few weeks, we will have more information.

For now, if you’re on an ACE or ARB, do not stop the medication. Talk to your doctor to get the latest recommendations. The research is ongoing, so it may change over time.

The Heart Failure Society of America

The American College of Cardiology

The European Society of Cardiology

The Nephrology Journal Club 

Reviewed by Arefa Cassoobhoy on April 15, 2020

The Heart Failure Society of America

The American College of Cardiology

The European Society of Cardiology

The Nephrology Journal Club 

Reviewed by Arefa Cassoobhoy on April 15, 2020

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