NOTeD: Hypertension Medications and Coronavirus

What to Do in Light of Internet Reports about Their Potential Interaction?
Tom Rifai, MD, FACP

IN TODAY’S MEDICAL NEWS: Hypertension Medications and Coronavirus Are a Bad Mix!

Hypertension itself (even if controlled by meds) is a major risk factor for succumbing to COVID-19 (i.e., the disease caused by this current coronavirus, also known as SARS-CoV-2). But are hypertension medications and coronavirus a bad mix? In other words, should you stop taking your hypertension medications out of fear you will get a worse case of COVID-19?

The short answer: NO, and certainly not without discussing with a licensed health provider, preferably your primary care doctor.

There has been unsubstantiated misinformation on the internet that if you are on an angiotensin-converting enzyme – “ACE” – or an angiotensin receptor blocker – “ARB” – medication to help control your hypertension, it puts you at increased risk for COVID-19. Note: ACE drugs have generic names that end in “pril”, such as lisinopril and ramipril, while ARB medications typically end with “sartan” like losartan and irbesartan.

This is an unproven opinion. Notably, there’s evidence from animal and pediatric studies suggesting these medications may actually protect against serious lung complications from viruses with similar mechanisms to the current novel coronavirus.

BOTTOM LINE: Are Hypertension Medications and Coronavirus a Bad Mix?

Here’s where Reality Meets Science: stopping a factually-based stroke and heart attack risk-reducing drug (events to which thousands succumb in the USA alone daily, with or without COVID-19, and for which flu and pneumonia vaccinations actually lower risk) to, hypothetically and based on unbalanced speculation in the midst of our current coronavirus pandemic, reduce the risk of death from this virus (SARS-CoV-2), would be unwise.

This is particularly in light of the likelihood that our overall national heart attack and stroke risk-reducing physical activity and risk-elevating sodium intake from packaged foods is going down and up, respectively, due to national shifts in behavior. So please try to keep perspective.

What might you do?

Now, if you want to work with your doctor to monitor your blood pressure closely while cutting back on or stopping an ACE or ARB medication with a specific blood pressure-controlling lifestyle change plan (especially quitting smoking which would be huge in all health aspects, including potentially reducing coronavirus death risk as well as overall death risk for sure) in the midst of all of this, that would in theory be quite reasonable.

Whether it is practical or not is up to you and your licensed healthcare provider to decide, but please – not “Dr Internet.” Feel free to share with your care provider information on the important consensus statement from several European and American cardiology societies. Stay as calm and wise as you can. We will, collectively, make it through this.