Tadic Marijana, Saeed Sahrai, Grassi Guido, Taddei Stefano, Mancia Giuseppe, Cuspidi Cesare
Department of Cardiology, University Hospital "Dr. Dragisa Misovic - Dedinje", Belgrade, Serbia.
Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
Front Cardiovasc Med. 2021 Feb 17;8:639222. doi: 10.3389/fcvm.2021.639222. eCollection 2021.
Coronavirus disease 2019 (COVID-19) has become a worldwide pandemic responsible for millions of deaths around the world. Hypertension has been identified as one of the most common comorbidities and risk factors for severity and adverse outcome in these patients. Recent investigations have raised the question whether hypertension represents a predictor of outcome in COVID-19 patients independently of other common comorbidities such as diabetes, obesity, other cardiovascular diseases, chronic kidney, liver, and pulmonary diseases. However, the impact of chronic and newly diagnosed hypertension in COVID-19 patients has been insufficiently investigated. The same is true for the relationship between blood pressure levels and outcomes in COVID-19 patients. It seems that the long discussion about the impact of angiotensin-converting enzyme inhibitors (ACEI) and blockers of angiotensin I receptors (ARB) on severity and outcome in COVID-19 is approaching an end because the large number of original studies and meta-analyses discarded the initial findings about higher prevalence of ACEI/ARB use in patients with unfavorable outcomes. Nevertheless, there are many controversies in the relationship between hypertension and COVID-19. The aim of this review article is to provide a clinical overview of the currently available evidence regarding the predictive value of hypertension, the effect of blood pressure levels, the impact of previously known and newly diagnosed hypertension, and the effect of antihypertensive therapy on the severity and outcomes in COVID-19 patients.
2019冠状病毒病(COVID-19)已成为一场全球大流行疾病,导致全球数百万人死亡。高血压已被确定为这些患者中最常见的合并症之一,也是病情严重程度和不良结局的危险因素。最近的研究提出了一个问题,即高血压是否独立于其他常见合并症(如糖尿病、肥胖症、其他心血管疾病、慢性肾脏、肝脏和肺部疾病)而成为COVID-19患者预后的预测指标。然而,慢性高血压和新诊断高血压对COVID-19患者的影响尚未得到充分研究。COVID-19患者的血压水平与预后之间的关系也是如此。关于血管紧张素转换酶抑制剂(ACEI)和血管紧张素I受体阻滞剂(ARB)对COVID-19严重程度和预后的影响的长期讨论似乎即将结束,因为大量的原始研究和荟萃分析否定了最初关于不良结局患者中ACEI/ARB使用患病率较高的发现。尽管如此,高血压与COVID-19之间的关系仍存在许多争议。这篇综述文章的目的是提供一个临床概述,介绍目前关于高血压预测价值、血压水平影响、既往已知和新诊断高血压的影响以及抗高血压治疗对COVID-19患者严重程度和预后的影响的现有证据。
Front Cardiovasc Med. 2021-2-17
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