COVID-19 and hypertension—evidence and practical management: Guidance from the HOPE Asia Network
Journal
Journal of Clinical Hypertension
Journal Volume
22
Journal Issue
7
Pages
1109-1119
Date Issued
2020
Author(s)
Kario K.
Morisawa Y.
Sukonthasarn A.
Turana Y.
Chia Y.-C.
Park S.
Chen C.-H.
Tay J.C.
Li Y.
Wang J.-G.
Abstract
There are several risk factors for worse outcomes in patients with coronavirus 2019 disease (COVID-19). Patients with hypertension appear to have a poor prognosis, but there is no direct evidence that hypertension increases the risk of new infection or adverse outcomes independent of age and other risk factors. There is also concern about use of renin-angiotensin system (RAS) inhibitors due to a key role of angiotensin-converting enzyme 2 receptors in the entry of the SARS-CoV-2 virus into cells. However, there is little evidence that use of RAS inhibitors increases the risk of SARS-CoV-2 virus infection or worsens the course of COVID-19. Therefore, antihypertensive therapy with these agents should be continued. In addition to acute respiratory distress syndrome, patients with severe COVID-19 can develop myocardial injury and cytokine storm, resulting in heart failure, arteriovenous thrombosis, and kidney injury. Troponin, N-terminal pro-B-type natriuretic peptide, D-dimer, and serum creatinine are biomarkers for these complications and can be used to monitor patients with COVID-19 and for risk stratification. Other factors that need to be incorporated into patient management strategies during the pandemic include regular exercise to maintain good health status and monitoring of psychological well-being. For the ongoing management of patients with hypertension, telemedicine-based home blood pressure monitoring strategies can facilitate maintenance of good blood pressure control while social distancing is maintained. Overall, multidisciplinary management of COVID-19 based on a rapidly growing body of evidence will help ensure the best possible outcomes for patients, including those with risk factors such as hypertension. ? 2020 Wiley Periodicals LLC
Subjects
angiotensin receptor blockers; angiotensin-converting enzyme inhibitors; biomarkers; cardiac injury; COVID-19; home blood pressure monitoring; hypertension; telemedicine
SDGs
Other Subjects
amino terminal pro brain natriuretic peptide; angiotensin converting enzyme 2; angiotensin receptor antagonist; beta adrenergic receptor blocking agent; calcium channel blocking agent; creatinine; D dimer; dipeptidyl carboxypeptidase inhibitor; thiazide diuretic agent; troponin; biological marker; dipeptidyl carboxypeptidase inhibitor; acute coronary syndrome; acute kidney failure; adult respiratory distress syndrome; blood pressure monitoring; blood pressure regulation; brain infarction; coronavirus disease 2019; creatinine blood level; cytokine storm; disease severity; health status; heart failure; heart muscle injury; human; hypertension; infection risk; kidney injury; monitoring; outcome assessment; priority journal; prognosis; psychological well-being; Review; risk factor; Severe acute respiratory syndrome coronavirus 2; social distance; telemedicine; vein thrombosis; venous thromboembolism; acute kidney failure; adult; aged; Asia; blood; complication; cytokine release syndrome; drug effect; female; genetics; heart failure; hypertension; immunology; interdisciplinary communication; male; middle aged; pandemic; procedures; renin angiotensin aldosterone system; risk assessment; thrombosis; very elderly; virology; Acute Kidney Injury; Adult; Aged; Aged, 80 and over; Angiotensin-Converting Enzyme 2; Angiotensin-Converting Enzyme Inhibitors; Asia; Biomarkers; Blood Pressure Monitoring, Ambulatory; COVID-19; Cytokine Release Syndrome; Female; Heart Failure; Humans; Hypertension; Interdisciplinary Communication; Male; Middle Aged; Pandemics; Renin-Angiotensin System; Risk Assessment; Risk Factors; SARS-CoV-2; Thrombosis
Publisher
Blackwell Publishing Inc.
Type
review