期刊
JOURNAL OF HYPERTENSION
卷 40, 期 12, 页码 2323-2336出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/HJH.0000000000003266
关键词
adverse outcomes; angiotensin-converting enzymes; angiotensin-renin blocker treatment; coronavirus disease 2019; hypertension; mortality
资金
- National Natural Science Foundation of China [82041022]
- Ministry of Science and Technology of the People's Republic of China [2018ZX10101003-001-003]
- Scientific Research Project of Shanghai Science and Technology Commission [20JC1410202, 20431900404]
- Key discipline from the '3-year public health promotion' program of Shanghai Municipal Health Commission [GWV-10.1-XK17]
- institutional research projects for naturalfocus infectious diseases and COVID-19
This study found that COVID-19 patients with hypertension are at increased risk of in-hospital mortality and other adverse outcomes, with variations observed across different age groups. ACEI/ARB treatments do not increase the in-hospital mortality of patients with hypertension.
Background: Hypertension and angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) have been reported to be associated with the prognosis of COVID-19, but the findings remain controversial. Here, we conducted a systematic review to summarize the current evidence. Methods: We retrieved all the studies by MEDLINE via PubMed, CENTRAL, and Embase using the MeSH terms until 30 April 2021. A fixed or random effect model was applied to calculate pooled adjusted odds ratio (AOR) with 95% confidence interval (CI). Interactive analysis was performed to identify the interaction effect of hypertension and age on in-hospital mortality. Results: In total, 86 articles with 18 775 387 COVID-19 patients from 18 countries were included in this study. The pooled analysis showed that the COVID-19 patients with hypertension had increased risks of in-hospital mortality and other adverse outcomes, compared with those without hypertension, with an AOR (95% CI) of 1.36 (1.28-1.45) and 1.32 (1.24-1.41), respectively. The results were mostly repeated in countries with more than three independent studies. Furthermore, the effect of hypertension on in-hospital mortality is more evident in younger and older COVID-19 patients than in 60-69-year-old patients. ACEI/ARBs did not significantly affect the mortality and adverse outcomes of COVID-19 patients, compared with those receiving other antihypertensive treatments. Conclusion: Hypertension is significantly associated with an increased risk of in-hospital mortality and adverse outcomes in COVID-19. The effect of hypertension on in-hospital mortality among consecutive age groups followed a U-shaped curve. ACEI/ARB treatments do not increase in-hospital mortality and other poor outcomes of COVID-19 patients with hypertension.
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