University Hospital "Dr. Dragisa Misovic - Dedinje", Department of Cardiology, Belgrade, Serbia.
University of Milan-Bicocca, Milan, Italy; Istituto Auxologico Italiano, Clinical Research Unit, Viale della Resistenza 23, 20036 Meda, Italy.
Pharmacol Res. 2020 Aug;158:104906. doi: 10.1016/j.phrs.2020.104906. Epub 2020 May 13.
The coronavirus disease (COVID-19) has spread all around the world in a very short period of time. Recent data are showing significant prevalence of arterial hypertension and cardiovascular diseases (CVD) among patients with COVID-19, which raised many questions about higher susceptibility of patients with these comorbidities to the novel coronavirus, as well as the role of hypertension and CVD in progression and the prognosis of COVID-19 patients. There is a very limited amount of data, usually obtained from a small population, regarding the effect of the underlying disease on the outcome in patients with COVID-19. The evaluation of the treatment of these comorbidities at baseline and during COVID-19 is scarce and the results are conflicting. Hypertension and CVD, after the adjustment for other clinical and demographic parameters, primarily age, did not remain independent predictors of the lethal outcome in COVID-19 patients. Some investigations speculated about the association between the renin-angiotensin-aldosterone system (RAAS) and susceptibility to COVID-19, as well as the relationship between RAAS inhibitors and the adverse outcome in these patients. Withdrawing or switching RAAS inhibitors would have uncertain benefits, but it would definitely have many disadvantages such as uncontrolled hypertension, cardiac function deterioration and renal function impairment, which could potentially induce more complications in patients with COVID-19 than the infection of coronavirus itself. The aim of this review article was to summarize the prevalence of hypertension and CVD in patients with COVID-19, their influence on the outcome and the effect of treatment of hypertension and CVD in COVID-19 patients.
新型冠状病毒病（COVID-19）在很短的时间内在全球范围内传播。最近的数据显示，COVID-19 患者中存在显著的动脉高血压和心血管疾病（CVD）患病率，这引发了许多关于这些合并症患者对新型冠状病毒更高易感性的问题，以及高血压和 CVD 在 COVID-19 患者进展和预后中的作用。关于基础疾病对 COVID-19 患者结局的影响，数据非常有限，通常是从小样本中获得的。关于这些合并症在 COVID-19 期间治疗的评估很少，而且结果相互矛盾。在调整其他临床和人口统计学参数（主要是年龄）后，高血压和 CVD 并未成为 COVID-19 患者致死结局的独立预测因素。一些研究推测了肾素-血管紧张素-醛固酮系统（RAAS）与 COVID-19 易感性之间的关联，以及 RAAS 抑制剂与这些患者不良结局之间的关系。停止或转换 RAAS 抑制剂的获益不确定，但肯定会有许多弊端，例如无法控制的高血压、心脏功能恶化和肾功能损害，这可能会导致 COVID-19 患者出现比冠状病毒感染本身更多的并发症。本文综述的目的是总结 COVID-19 患者中高血压和 CVD 的患病率、它们对结局的影响以及 COVID-19 患者中高血压和 CVD 治疗的效果。
