COVID-19: No worse prognosis due to blood pressure medication

COVID-19: No worse prognosis due to blood pressure medication

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Blood pressure medication is not a risk factor for severe COVID-19 courses, according to the study

Many patients are unsettled by current speculations: lowering blood pressure could make them more susceptible to coronavirus infections or lead to more severe COVID-19 diseases. A new study now comes to reassuring results: According to the researchers, blood pressure medication is not a risk factor for serious illnesses.

As the German Hypertension League wrote in a statement, a recent study from China has shown that patients who take antihypertensive drugs do not have a worse prognosis than other people when they develop COVID-19. The possibility of the COVID-19 course being influenced by hypotensive agents had previously been classified by the experts as unlikely and highly speculative.

Fear is demonstrably wrong

The novel coronavirus SARS-CoV2 uses ACE2 ("angiotensin converting enzyme 2") as a kind of "door opener" to enter the cells. ACE2 is located on the cell membrane and is formed in many organs, for example in the heart, kidneys, in the gastrointestinal tract and in the lungs.

As a result, there has been constant fear that antihypertensive therapy with ACE inhibitors (ACEI) and angiotensin receptor blockers (ARB), which include the so-called sartans, could increase the risk of a more severe course of COVID-19 disease - this is demonstrably wrong.

A recent study from China, published in the specialist magazine "JAMA Cardiology", showed that hypertension patients who take these drugs have no worse prognosis than other people if they develop COVID-19.

New data ensure high security

Data from over 1,100 people affected by COVID-19 were evaluated. It was shown that the proportion of patients who had previously been treated with ACEI / ARB did not differ significantly between the groups with severe and mild disease courses (32.9 percent vs. 30.7 percent; p = 0.645).

Even among the deceased, the proportion of those who had previously received high blood pressure therapy was not significantly higher than that of people with high blood pressure.

The study also showed that whether the patients had been treated with ACEI or ARB did not matter for COVID-19 history.

"The new data can therefore give practitioners and patients a high level of security, because it is ultimately a question of evaluating a large number of patients with a clear result: prior treatment with antihypertensives did not affect the outcome of Covid 19 patients," explains Prof. Dr. med. Ulrich Wenzel, Hamburg, CEO of the German High Pressure League DHL®.

Do not switch blood pressure medication

The experts had previously classified the possibility of influencing the COVID-19 course by ACEI or ARB as unlikely and highly speculative.

ACE2, to which Sars-Cov-2 binds, and ACE, which inhibit antihypertensive drugs, are two completely different enzymes. In addition, animal experimental findings that the formation of ACE2 expression increases under ARB are not consistent and varied depending on the ARB and organ.

Overall, according to the high pressure league, there are no data that suggest that ACEI or ARB favor SARS-CoV-19 infection by an increase in ACE2, in short: the drugs do not make them more susceptible to COVID-19 disease.

"The 'European Society of Hypertension' came to this assessment a few days ago. In a statement, she recommends that you do not change your blood pressure medication, either for fear of Covid 19 disease or for Covid 19 disease, ”says Professor Florian Limbourg, Hanover, board member of the German Hypertension League DHL®.

"These recommendations were endorsed by the German Hypertension League and we see this recommendation as confirmed by the current data from China." (Ad)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.


  • Li J, Wang X, Chen J et al .: Association of Renin-Angiotensin System Inhibitors With Severity or Risk of Death in Patients With Hypertension Hospitalized for Coronavirus Disease 2019 (COVID-19) Infection in Wuhan, China; in: JAMA Cardiology, (published: April 23, 2020), JAMA Cardiology
  • Danser AHJ, Epstein M, Batlle D .: Renin-Angiotensin System Blockers and the COVID-19 Pandemic; in: Hypertension, (published: 25.03.2020), Hypertension

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