- The presidents of 3 cardiovascular societies recommend that patients currently taking renin-angiotensin-aldosterone system (RAAS) inhibitors continue to do so.
- For patients diagnosed with COVID-19, continuation should be considered on an individual basis, they say.
Why this matters
- The presidents of the Heart Failure Society of America, American College of Cardiology, and the American Heart Association are in agreement with the European Society of Hypertension in this recommendation.
- The virus that causes COVID-19 gains cell entry via the angiotensin-converting enzyme (ACE) 2 receptor.
- ACEs are implicated in cardiovascular diseases, including hypertension and heart failure.
- Existing cardiovascular disease is a risk factor for poor outcomes in COVID-19.
- Some heart-related effects of the causative virus have been identified, as well.
- RAAS inhibitors include antagonists of ACE, along with angiotensin receptor blockers.
- Some have speculated that current therapy with these drugs might enhance infection vulnerability.
- Results of in vitro and animal studies have been mixed.
- In the absence of evidence, societies call for continuing RAAS-inhibitor therapy in patients without COVID-19.
- In those who are diagnosed with COVID-19, therapy decisions should be based on individual clinical status.