The Italian Society of Hypertension presented a reasoned statement to maintain ongoing antihypertensive treatments. Furthermore, it unveiled its own initiative to investigate the issue using an online questionnaire to collect relevant data in human disease.
The recent Severe Acute Respiratory Syndrome (SARS) due to Coronavirus 2 (CoV-2) infection pandemic and subsequent spread of the disease called COVID-19 brought back to discussion a topic already highlighted during the SARSCoV- 1 and the Middle East Respiratory Distress Syndrome (MERS) of 2002 and 2013. During those outbreaks it was observed a particularly elevated incidence of cardiovascular disease among patients, who were also characterized by being elderly and, in particular during the MERS, prevalently male. Another main topic of discussion is the role of angiotensin converting enzyme (ACE) 2 in relation to which there is a strong concern that treatment with renin-angiotensin system inhibitors (RAS) could make the symptoms of COVID-19 extremely serious due to the increased expression of ACE2.
As highlighted by the Statement, both the abovementioned issues have been re-proposed in the occurrence of the present epidemic of COVID-19. In particular, the issue of the prevalence of cardiovascular diseases among COVID-19 patients is proposed by observational data obtained in Chinese and Italian patients. However, it still lacks the analysis of the confounding effects of age on the apparent association between cardiovascular disease COVID-19 infection and clinical severity.
In line with the statements by other International Societies, such as the European Society of Hypertension, the Italian Society of Hypertension – SIIA states that:
– there is no evidence to associate hypertension or other CVDs with COVID-19 disease
– there is no clinical evidence in humans that associates the intake of ACE inhibitors or ARBs with COVID-19 disease
– There are no clinical data in patients that can confirm the harmful effect (not even the protective one) of ACE inhibitors and ARB in the context of the COVID- 19 epidemic.
Finally, in order to clarify which mechanism is prevalent and has a role in the clinical manifestation of COVID-19, SIIA has launched a fact-finding investigation to verify the impact of therapy with inhibitors of the renin-angiotensin system on the onset and clinical manifestation of the disease COVID- 19. This observational research is based on an online questionnaire made of 18 questions with the aim of collecting information on medical history and the evolution of the disease in COVID19 patients.