Use of distinct anti-hypertensive drugs and risk for COVID-19 among hypertensive people: a population-based cohort study in Southern Catalonia, Spain
Use of distinct anti-hypertensive drugs and risk for COVID-19 among hypertensive people: a population-based cohort study in Southern Catalonia, Spain
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DOI：
10.1111/jch.13948
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发表时间：
2020-07-25
影响因子：
2.8
通讯作者：
Basora-Gallisa, Josep
中科院分区：
文献类型：
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作者：
Vila-Corcoles, Angel;Satue-Gracia, Eva;Basora-Gallisa, Josep
在当前的 COVID-19 大流行中，某些抗高血压药物的使用引起了争议。本研究调查了动态高血压人群中抗高血压药物的使用与 COVID-19 感染风险之间的可能关系。这是一项基于人群的回顾性队列研究，涉及塔拉戈纳（西班牙加泰罗尼亚南部）的 34 936 名 50 岁以上高血压成年人，他们在大流行期间（2020 年 3 月 1 日至 2020 年 4 月 30 日）进行了回顾性随访。将包括人口统计/临床特征（合并症和心血管药物使用）和 COVID-19 实验室 PCR 代码在内的两个数据集关联起来，构建了一个匿名研究数据库。 Cox 回归用于计算多变量风险比 (HR) 并估计感染 COVID-19 的风险。在整个研究期间，观察到 205 例 PCR 确诊的 COVID-19 病例，这意味着每 10 万人中的总发病率为 586.8 例。在多变量分析中，只有年龄（HR：1.03；95% CI：1.02-1.05；P < .001）和疗养院居住地（HR：19.60；95% CI：13.80-27.84；P < .001）似乎与 COVID-19 风险增加显着相关。考虑抗高血压药物，接受利尿剂（HR：1.22；95% CI：0.90-1.67；P = .205）、钙通道阻滞剂（HR：1.29；95% CI：0.91-1.82；P = .148）、β-受体阻滞剂（HR：0.97；95% CI： 0.68-1.37；P = .844）和血管紧张素转换酶抑制剂（HR：0.83；95% CI：0.61-1.13；P = .238）并没有显着改变 PCR 确诊的 COVID-19 风险，而接受血管紧张素 II 受体阻滞剂与几乎具有统计学意义的风险降低相关（HR：0.67；95% CI： 0.44-1.01；P = .054)。总之，我们的数据支持，接受肾素-血管紧张素-醛固酮系统抑制剂不会导致动态高血压患者感染 COVID-19。相反，接受血管紧张素 II 受体阻滞剂可能与风险降低有关。
The use of some anti-hypertensive drugs in the current COVID-19 pandemic has become controversial. This study investigated possible relationships between anti-hypertensive medications use and COVID-19 infection risk in the ambulatory hypertensive population. This is a population-based retrospective cohort study involving 34 936 hypertensive adults >50 years in Tarragona (Southern Catalonia, Spain) who were retrospectively followed through pandemic period (from 01/03/2020 to 30/04/2020). Two data sets including demographic/clinical characteristics (comorbidities and cardiovascular medications use) and laboratory PCR codes for COVID-19 were linked to construct an anonymized research database. Cox regression was used to calculate multivariable hazard ratios (HRs) and estimate the risk of suffering COVID-19 infection. Across study period, 205 PCR-confirmed COVID-19 cases were observed, which means an overall incidence of 586.8 cases per 100 000 persons-period. In multivariable analyses, only age (HR: 1.03; 95% CI: 1.02-1.05;P < .001) and nursing home residence (HR: 19.60; 95% CI: 13.80-27.84;P < .001) appeared significantly associated with increased risk of COVID-19. Considering anti-hypertensive drugs, receiving diuretics (HR: 1.22; 95% CI: 0.90-1.67;P = .205), calcium channel blockers (HR: 1.29; 95%CI: 0.91-1.82;P = .148), beta-blockers (HR: 0.97; 95% CI: 0.68-1.37;P = .844), and angiotensin-converting enzyme inhibitors (HR: 0.83; 95% CI: 0.61-1.13;P = .238) did not significantly alter the risk of PCR-confirmed COVID-19, whereas receiving angiotensin II receptor blockers was associated with an almost statistically significant reduction risk (HR: 0.67; 95% CI: 0.44-1.01;P = .054). In conclusion, our data support that receiving renin-angiotensin-aldosterone system inhibitors does not predispose for suffering COVID-19 infection in ambulatory hypertensive people. Conversely, receiving angiotensin II receptor blockers could be related with a reduced risk.