Continue ACE inhibitors and ARBs amid COVID-19 outbreak

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Goodfellow Gems

Continue ACE inhibitors and ARBs amid COVID-19 outbreak

Patients should not stop taking their angiotensin-converting-enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs), despite theoretical concerns that their use might worsen outcomes in the event of infection with COVID-19, according to a new statement from the American Heart Association, the American College of Cardiology, the Heart Failure Society of America and the European Society of Hypertension.1

An article published in Lancet Resp Medicine 11 March 2020 suggested that coronavirus can bind to target cells through ACE-2 receptors, and speculates that ACE-2 upregulation from ACEI and ARB could increase the risk of developing severe and fatal COVID-19.  There is no clinical data to support that contention.

At this point the risk to a patients health from cardiovascular causes and events of stopping these medications would outweigh any theoretical harm from COVID -19.

This GEM has the support of Associate Professors Rinki Murphy and Gerry Devlin and Dr Hari Talreja

Reference:

  1. Heart Groups: Patients with COVID-19 Should Continue ACE Inhibitors & ARBs NEJM (2020) View here

Gems are chosen by the Goodfellow director Dr. Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.