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Inicio Medicina Clínica (English Edition) Risk of severe COVID-19 in hypertensive patients treated with renin-angiotensin-...
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Vol. 155. Issue 11.
Pages 488-490 (December 2020)
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Vol. 155. Issue 11.
Pages 488-490 (December 2020)
Brief report
Risk of severe COVID-19 in hypertensive patients treated with renin-angiotensin-aldosterone system inhibitors
Riesgo de COVID-19 grave en pacientes hipertensos tratados con inhibidores del sistema renina-angiotensina-aldosterona
Rafael Golpea,
Corresponding author

Corresponding author. c/Dr Ulises Romero 1, 27002 Lugo, Spain.
, Luis A. Pérez-de-Llanoa, David Dacala, Hector Guerrero-Sandeb, Beatriz Pombo-Videb, Pablo Ventura-Valcárcelb, On behalf of the Lugo Covid-19 team
a Servicio de Neumología, Hospital Universitario Lucus Augusti, Lugo, Spain
b Servicio de Medicina Interna, Hospital Universitario Lucus Augusti, Lugo, Spain
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Tables (2)
Table 1. differences between patients admitted to the hospital and those managed as outpatients.
Table 2. Results of the univariable and multivariable logistic regression analysis for the risk of hospital admission.
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There is controversy concerning the use of angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II type-I receptor blockers (ARB) for treating hypertensive patients with Covid-19. It has been hypothesized that these drugs might increase the risk of severe Covid-19, but some authors suggested that blocking the renin-angiotensin system might actually decrease this risk.


Retrospective cohort study of all the consecutive hypertensive patients with confirmed SARS-CoV-2 infection in a health area. The outcome variable was hospitalization because of severe Covid-19.


539 subjects were diagnosed of SARS-CoV-2 infection. Of these, 157 (29.1%) had hypertension and were included in the study. Sixty-nine cases (43.9%) were hospitalized because of severe Covid-19. In multivariable analysis older age, diabetes and hypertensive myocadiopathy were related to a higher risk of hospital admission. ARB treatment was associated with a significantly lower risk of hospitalization (HR: 0.29, 95% CI: 0.10 – 0.88). A similar albeit not significant trend was observed for ACEI.


ARB or ACEI treatment was not associated with a worse clinical outcome in consecutive hypertensive patients infected by SARS-CoV-2.

Angiotensin-converting enzyme inhibitors
Angiotensin II type-I receptor blockers

Existe controversia respecto al uso de los inhibidores de la enzima convertidora de angiotensina (IECA) o los bloqueadores de los receptores tipo I de la angiotensina II (ARA-II) para el tratamiento de la hipertensión arterial en COVID-19. Se ha sugerido que estos fármacos podrían tanto aumentar como reducir el riesgo de COVID-19 grave.

Pacientes y método

Estudio de cohortes retrospectivo de pacientes consecutivos de un área sanitaria, con hipertensión e infección por SARS-CoV-2. Variable de resultados: ingreso hospitalario por COVID-19 grave.


Fueron diagnosticados 539 sujetos por infección por SARS-CoV-2. De estos, 157 (29,1%) eran hipertensos y se incluyeron en el estudio. Se ingresaron 69 (43,9%) pacientes por COVID-19 grave. En el análisis multivariante, la edad más elevada, la diabetes y la miocardiopatía hipertensiva se relacionaron con el riesgo de ingreso hospitalario. El tratamiento con ARA-II se asoció con un riesgo significativamente más bajo de ingreso (HR: 0,29, IC 95%: 0,10-0,88). Una tendencia similar, aunque no significativa, se encontró para los IECA.


el tratamiento con ARA-II o IECA no se asoció con una peor evolución clínica en pacientes hipertensos consecutivos infectados por SARS-CoV-2.

Palabras clave:
Inhibidores de la enzima convertidora de angiotensina
Bloqueadores tipo I de angiotensina-II


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