Post by Beth on Mar 30, 2020 4:56:02 GMT
I had a call today with a very smart colleague and friend who is a well-regarded cardiologist. Our call focused on emerging debates regarding the possibility that medications taken for heart conditions and high blood pressure may be linked to the development of more severe COVID-19 symptoms. It is at least a possibility that this may be a factor in the higher rates of death among people with high blood pressure and heart disease. The concern in over-simplified terms, is that the medications -- due to their effect on the cells of patients -- may be making it easier for the Coronavirus to take root in a patient's lower respiratory system, leading to viral pneumonia.
When a disease is as new as the Novel Coronavirus 2019 -- different theories or correlations may initially emerge, and might later prove to have no real weight behind them. It takes time to understand a particular disease pathology, and not enough time has passed yet.
With that said, the concern is about two classes of medication -- ACE-inhibitors (typically medications with generic names ending in "pril"), and Angiotensin Receptor Blockers or ARBS (typically medications with generic names ending in "sartan").
For more about the current scientific discussions, see the attached PDF here: (COVID19 and BP meds in Lancet.pdf (65.12 KB)). Note again, that the question of a link between these medications and COVID-19 is currently contested, and you will be able to find other sources claiming there is no real evidence. That is, there is no scientific consensus as yet about whether there is a good enough reason to take patients with COVID-19 off of these medications.
What to Make of This Information:
With the disclaimer that I'm not qualified to give any medical advice whatsoever, and this is just my individual opinion:
If you are taking an ACE-inhibitor or ARB medication, and do not have any COVID-19 symptoms, I don't see a reason to be immediately concerned. No one is suggesting that the medications would increase the risk of contracting an infection to begin with -- the only question is whether it might make the infection more severe if you do become ill. One thing you might consider is asking for a prescription for a different class of heart or blood pressure medication to fill (by mail!) and keep in the house, in case you did decide you needed to switch later. Calcium-Channel Blockers, Beta-Blockers, and Diuretics, for instance, are not under scrutiny relative to COVID-19. If you are switching medications, it's also helpful to be able to monitor your blood pressure at home, so this is a good time to get a battery powered or plug-in home blood pressure cuff (not too expensive, thankfully), if you don't have one. They are available through many vendors online.
If you do have COVID-19 symptoms (even if mild), and are taking an ACE-inhibitor or an ARB medication, I would reach out to your primary care provider (or cardiologist if you have one) ASAP to discuss the risks and benefits of switching medications. Keep in mind that some primary care physicians may be hesitant to act without a clear standard of care, or may not be following the current controversies, so if you feel strongly about the concern, don't hesitate to be insistent about making a change. Ultimately as a patient, it's always your right to decide whether or not to take a particular medication.
Note that just rapidly discontinuing blood pressure or heart medication, depending on the condition, can be dangerous -- so I wouldn't quit taking medication without an alternative, or without consulting with your doctor first.
Please feel free to share this message freely.
When a disease is as new as the Novel Coronavirus 2019 -- different theories or correlations may initially emerge, and might later prove to have no real weight behind them. It takes time to understand a particular disease pathology, and not enough time has passed yet.
With that said, the concern is about two classes of medication -- ACE-inhibitors (typically medications with generic names ending in "pril"), and Angiotensin Receptor Blockers or ARBS (typically medications with generic names ending in "sartan").
For more about the current scientific discussions, see the attached PDF here: (COVID19 and BP meds in Lancet.pdf (65.12 KB)). Note again, that the question of a link between these medications and COVID-19 is currently contested, and you will be able to find other sources claiming there is no real evidence. That is, there is no scientific consensus as yet about whether there is a good enough reason to take patients with COVID-19 off of these medications.
What to Make of This Information:
With the disclaimer that I'm not qualified to give any medical advice whatsoever, and this is just my individual opinion:
If you are taking an ACE-inhibitor or ARB medication, and do not have any COVID-19 symptoms, I don't see a reason to be immediately concerned. No one is suggesting that the medications would increase the risk of contracting an infection to begin with -- the only question is whether it might make the infection more severe if you do become ill. One thing you might consider is asking for a prescription for a different class of heart or blood pressure medication to fill (by mail!) and keep in the house, in case you did decide you needed to switch later. Calcium-Channel Blockers, Beta-Blockers, and Diuretics, for instance, are not under scrutiny relative to COVID-19. If you are switching medications, it's also helpful to be able to monitor your blood pressure at home, so this is a good time to get a battery powered or plug-in home blood pressure cuff (not too expensive, thankfully), if you don't have one. They are available through many vendors online.
If you do have COVID-19 symptoms (even if mild), and are taking an ACE-inhibitor or an ARB medication, I would reach out to your primary care provider (or cardiologist if you have one) ASAP to discuss the risks and benefits of switching medications. Keep in mind that some primary care physicians may be hesitant to act without a clear standard of care, or may not be following the current controversies, so if you feel strongly about the concern, don't hesitate to be insistent about making a change. Ultimately as a patient, it's always your right to decide whether or not to take a particular medication.
Note that just rapidly discontinuing blood pressure or heart medication, depending on the condition, can be dangerous -- so I wouldn't quit taking medication without an alternative, or without consulting with your doctor first.
Please feel free to share this message freely.