ACE inhibitors and ARBs do not make coronavirus worse

Drugs commonly prescribed to treat high blood pressure do not worsen coronavirus (Covid-19) disease, according to research we part-funded.

The researchers at Kings College London found that there was no link between the use of angiotensin-converting enzyme (ACE) inhibitors, used to treat blood pressure or diabetes, and the severity of Covid-19. The use of angiotensin receptor blockers (ARBs), used to treat high blood pressure and heart failure, also did not worsen Covid-19 disease severity in people hospitalised with the virus.

The team looked at the data of 1,200 people with Covid-19 admitted to two hospitals at the King’s College Hospital NHS Foundation Trust with symptoms from 1st March to 13th April 2020.

Severe cases were detected as those who were either transferred to a critical care unit or who died. They were compared to people who were treated with and without ACE inhibitors and ARBs. Of the 1,200 patients, 415 people (35 per cent) died or required critical care support within 21 days of symptoms and 33 per cent were taking ACE inhibitors or ARBs. Their findings indicated that the likelihood of severe disease was similar in individuals on ACE inhibitors or ARBs compared to those not on these drugs.

The average age was 68 years, 74 per cent of people had at least one comorbidity and they were of diverse ethnicities with over 30 per cent from minority ethnic groups.

ACE inhibitors and ARBs have been of great interest to Covid-19 researchers as they increase levels of ACE2, a molecule which sits on cell surfaces within the body and acts as the doorway for Covid-19 to enter.

ACE inhibitors and ARBs are safe to use

Professor Sir Nilesh Samani, our Medical Director, said:

“The use of ACE inhibitors and ARBs has been a hot topic of debate since the start of the coronavirus pandemic. This left millions of people living with heart and circulatory conditions questioning whether they should continue to take their heart medications.

“This UK study, which is the first to include significant proportions of people from both white and minority ethnic backgrounds, adds to other recent evidence confirming these medications do not increase the risk of severe Covid-19 infections. These drugs are very effective for heart failure, and to control high blood pressure to help prevent a heart attack or stroke. This study provides further reassurance that their use is safe and that it is important that patients continue to take them as prescribed to protect cardiovascular health."

Covid-19 and heart or circulatory diseases