COVID-19 and hypertension—evidence and practical management: Guidance from the HOPE Asia Network

Kazuomi Kario*, Yuji Morisawa, Apichard Sukonthasarn, Yuda Turana, Yook Chin Chia, Sungha Park, Tzung Dau Wang, Chen Huan Chen, Jam Chin Tay, Yan Li, Ji Guang Wang

*此作品的通信作者

研究成果: Review article同行評審

43 引文 斯高帕斯(Scopus)

摘要

There are several risk factors for worse outcomes in patients with coronavirus 2019 disease (COVID-19). Patients with hypertension appear to have a poor prognosis, but there is no direct evidence that hypertension increases the risk of new infection or adverse outcomes independent of age and other risk factors. There is also concern about use of renin-angiotensin system (RAS) inhibitors due to a key role of angiotensin-converting enzyme 2 receptors in the entry of the SARS-CoV-2 virus into cells. However, there is little evidence that use of RAS inhibitors increases the risk of SARS-CoV-2 virus infection or worsens the course of COVID-19. Therefore, antihypertensive therapy with these agents should be continued. In addition to acute respiratory distress syndrome, patients with severe COVID-19 can develop myocardial injury and cytokine storm, resulting in heart failure, arteriovenous thrombosis, and kidney injury. Troponin, N-terminal pro-B-type natriuretic peptide, D-dimer, and serum creatinine are biomarkers for these complications and can be used to monitor patients with COVID-19 and for risk stratification. Other factors that need to be incorporated into patient management strategies during the pandemic include regular exercise to maintain good health status and monitoring of psychological well-being. For the ongoing management of patients with hypertension, telemedicine-based home blood pressure monitoring strategies can facilitate maintenance of good blood pressure control while social distancing is maintained. Overall, multidisciplinary management of COVID-19 based on a rapidly growing body of evidence will help ensure the best possible outcomes for patients, including those with risk factors such as hypertension.

原文English
頁(從 - 到)1109-1119
頁數11
期刊Journal of Clinical Hypertension
22
發行號7
DOIs
出版狀態Published - 1 7月 2020

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