COVID-19 and hypertension—evidence and practical management: Guidance from the HOPE Asia Network

Kazuomi Kario, Yuji Morisawa, Apichard Sukonthasarn, Yuda Turana, Yook Chin Chia, Sungha Park, Tzung Dau Wang, Chen Huan Chen, Jam Chin Tay, Yan Li, Ji Guang Wang

Research output: Contribution to journalReview articlepeer-review

8 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1109-1119
Number of pages11
JournalJournal of Clinical Hypertension
Volume22
Issue number7
DOIs
Publication statusPublished - 2020 Jul 1

Bibliographical note

Funding Information:
We would like to express our gratitude to Ayako Okura, the academic editorial coordinator of the Department of Cardiology, Jichi Medical School, and Yukiko Suzuki, the academic coordinator, for their assistance with data gathering and figure preparation. Medical writing assistance was provided by Nicola Ryan, independent medical writer, funded by Jichi Medical University.

Funding Information:
We would like to express our gratitude to Ayako Okura, the academic editorial coordinator of the Department of Cardiology, Jichi Medical School, and Yukiko Suzuki, the academic coordinator, for their assistance with data gathering and figure preparation. Medical writing assistance was provided by Nicola Ryan, independent medical writer, funded by Jichi Medical University.

Publisher Copyright:
© 2020 Wiley Periodicals LLC

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine

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