COVID-19 and the Use of Angiotensin II Receptor Blockers in Older Chronic Hypertensive Patients: Systematic Review and Meta-Analysis

Quesada-Caballero, Miguel; Carmona-García, Ana; Chami-Peña, Sara; Albendín-García, Luis; Membrive-Jiménez, Cristina; Romero-Béjar, José L.; Cañadas-De la Fuente, Guillermo A.

doi:10.3390/medicina59071200

Cited by 3 publications

(1 citation statement)

References 64 publications

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“…The main treatment for chronic hypertensive patients is the use of angiotensin II receptor blockers [3]. These drugs are safe and have been recommended in the context of COVID-19 [4]. Heart disease currently accounts for 16% of all deaths from all causes [5,6], and arterial hypertension (AHT) remains the most prevalent cause of cardiovascular morbidity and mortality [7].…”

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confidence: 99%

Assessing the Risk of Hypertension in Chronic, Elderly Patients during the COVID-19 Pandemic: A Prospective Study

Quesada-Caballero,

Carmona-García,

García-Lara

et al. 2024

JCDD

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Background: This study considers care management for older chronic patients during and after the COVID-19 pandemic. Aims: To identify groups of variables at previous time points as a basis for deriving efficient classification models during and after a pandemic situation and to quantify the effect of each variable within the model to predict levels of worsening risk in diastolic and systolic arterial hypertension (AHT). Material and Methods: In this prospective longitudinal study, data were collected at three time points: before, during, and after the COVID-19 pandemic period. Results: The study included 148 patients with an average age of 81.6 years. During the study period, mean systolic blood pressure among this population rose by 5 mmHg to 128.8 mmHg; the number of patients with systolic blood pressure > 140 mmHg rose by 45.3%; among those with diastolic blood pressure > 90, the number rose by 41.2%; mean triglycerides levels rose to 152.6 mg/dL; cholesterol levels rose to 147 mg/dL; and LDL cholesterol rose to 112.2 mg/dL. Meanwhile, mean levels of HDL cholesterol decreased to 46.5 mg/dL. Binary-response logistic regression models were constructed to identify the most relevant variables for predicting AHT risk during and after the pandemic. The heart rate (OR = 1.79; 95% CI: 1.22–2.72) and body mass index (OR = 1.75; 95% CI: 1.08–2.94) variables were significant at the population level (p < 0.05) for diastolic and systolic AHT in the pandemic period risk models. The body mass index variable was also significant for diastolic AHT in the post-pandemic period risk model (OR = 1.97; 95% CI: 1.32–2.94), whilst the triglycerides variable was significant in the systolic AHT post-pandemic period risk model (OR = 1.49; 95% CI: 1.01–1.86). Conclusions: Bad control of arterial hypertension in older patients with chronic disease is associated with elevated levels of LDL cholesterol, total cholesterol, systolic blood pressure, heart rate and triglycerides, and lower levels of HDL cholesterol.

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Section: Introductionmentioning

confidence: 99%

Assessing the Risk of Hypertension in Chronic, Elderly Patients during the COVID-19 Pandemic: A Prospective Study

Quesada-Caballero,

Carmona-García,

García-Lara

et al. 2024

JCDD

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Baseline NT-proBNP levels as a predictor of short-and long-term prognosis in COVID-19 patients: a prospective observational study

Mojón-Álvarez,

Giralt,

Carreras-Mora

et al. 2024

BMC Infect Dis

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Background Up to 20% of COVID-19 patients can suffer COVID-19-related myocardial injury. Elevated cardiac biomarkers, such as hs-cTnT and NT-proBNP, have been related to worse short-term prognosis. However, data on NT-proBNP and long-term prognosis are scarce. We have evaluated the potential association of baseline age-adjusted NT-proBNP levels and outcomes at one-year follow-up in COVID-19 patients. Methods This was a single-center prospective study of 499 COVID-19 patients in whom NT-proBNP was assessed at hospital admission. NT-proBNP levels were age-adjusted and patients were classified as high or low NT-proBNP. Clinical and demographic characteristics, comorbidities, laboratory results, and in-hospital complications and mortality were compared between the two groups. Survivors of the acute phase of COVID-19 were followed up for one year from admission to detect readmissions and mortality. Results The 68 patients with high NT-proBNP levels at hospital admission were older, with more cardiovascular risk factors, cardiovascular disease, comorbidities, myocardial injury, and higher levels of inflammatory markers than patients with low NT-proBNP levels. They also had more in-hospital complications and a higher acute-phase mortality rate (60.3% vs. 10.2%, p < 0.001). High NT-proBNP levels were an independent marker of death during hospitalization (HR 1.95; CI 1.07–3.52). At one-year follow-up, high NT-proBNP levels were independently associated with mortality (HR 2.69; CI 1.47–4.89). Among survivors of the acute phase of COVID-19, there were no differences in hospital readmissions between those with high vs. low NT-proBNP levels, but survivors with high baseline NT-proBNP levels showed a higher 1-year mortality rate (7.4% vs. 1.3%, p = 0.018). Conclusions High age-adjusted NT-proBNP levels at the time of hospital admission for COVID-19 are associated with poor short and long-term prognosis. High NT-proBNP seems also to be related to worse prognosis in survivors of the acute phase of COVID-19. A closer follow-up on these patients may be crucial.

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Evaluating the Mortality Risk Factors Among COVID-19 Patients with Diabetes Mellitus

Pouladzadeh,

Zakerkish,

Rashidi

et al. 2024

Jundishapur J Chronic Dis Care

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Background: Management of Coronavirus disease 2019 (COVID-19) patients with underlying disorders is a challenging issue at any time. Objectives: The present survey investigated the mortality rate of COVID-19 patients with various underlying disorders. Methods: In the present cross-sectional study, patients with COVID-19 who were referred to the Razi Hospital in Ahvaz from Feb 2020 to Oct 2020 were evaluated. Non-probability sampling method was used for sample collection. All documented information, including length of hospitalization, comorbidities, survival, and clinical and laboratory findings, were collected. Results: In the present study, 500 diabetic patients with COVID-19 infection were included. The mean age of participants was 59.61 ± 14.88 years old. Of the subjects, 192 (38.4%) were female and 308 (61.6%) were male. DM solely was the most frequent underlying disorder (46.2%), followed by co-occurrence of DM and hypertension (HTN) (43%). The mortality rate was 15% and was more frequent in patients with simultaneous DM and HTN (66%) (P-value < 0.001). Also, the mortality rate was significantly higher in males than females (72% vs 28%) (P-value = 0.042). Further analysis indicated that the mean of white blood cells (WBC), neutrophil count, blood urea nitrogen, glucose, creatinine, and aspartate aminotransferase were significantly higher in expired patients (P-value < 0.05). Post Hoc analysis showed the highest pulse rate (PR) and respiratory rate (RR) in patients with DM, HTN, and chronic obstructive pulmonary disease (COPD) (P-value < 0.001). Conclusions: The present investigation showed that comorbidities significantly increase the COVID-19 mortality rate. Our findings revealed that more attention is required for COVID-19 patients with HTN and DM. Due to discrepancies with recent investigations, further studies with more follow-up are recommended.

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COVID-19 and the Use of Angiotensin II Receptor Blockers in Older Chronic Hypertensive Patients: Systematic Review and Meta-Analysis

Cited by 3 publications

References 64 publications

Assessing the Risk of Hypertension in Chronic, Elderly Patients during the COVID-19 Pandemic: A Prospective Study

Assessing the Risk of Hypertension in Chronic, Elderly Patients during the COVID-19 Pandemic: A Prospective Study

Baseline NT-proBNP levels as a predictor of short-and long-term prognosis in COVID-19 patients: a prospective observational study

Evaluating the Mortality Risk Factors Among COVID-19 Patients with Diabetes Mellitus

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