Dr. Whitney Opinion About ACEI/ARB Blood Pressure Meds

Posted on March 23, 2020 | Posted by

The following is my opinion for anyone on ACEI or ARB blood pressure meds like ramipril, lisinopril, and other “…prils”, or losartan and other “…artans”. Consider forwarding this if you know someone on these meds.

Increasingly, I am being asked by patients whether they should continue these medications.  I have researched this topic, and the following is my opinion based on today’s information.  I will attempt to explain a complicated topic in terms you can understand.

Worldwide researchers are associating high blood pressure as a significant risk for complications from COVID-19.  They are finding that the virus is attaching to human cells through angiotensin receptors.  People with high blood pressure have more angiotensin receptor activity than those with normal blood pressure.  These medications block the angiotensin receptors, which is how they reduce blood pressure.

Some commentators are theorizing that the medications might place a person at higher risk of complications from coronavirus.  They are saying that it might be the medications increasing the complications.  This is currently just theory, not proven and I am currently recommending that people do NOT discontinue the medications at this point for 2 reasons:

  1. Being on these medications possibly could reduce your risk of coronavirus complications.  I have a big problem with the leap of faith linking of medication to being the cause of the association of COVID-19 complications.  Worldwide very few patients are on ACEI/ARB meds.  The meds work by blocking these receptors that are overactive.  We know they work on blood vessels and kidney cells, and if they work on lung cells, they could be protective.
  2. Also, ACEI and possibly ARB meds reduce your risk of heart attack and stroke independent of their benefit on blood pressure.  Influenza dramatically increases your risk of heart attack and stroke because it is a very pro-inflammatory event.  Evidence is suggesting that COVID-19 might be more inflammatory than influenza so you’d benefit from the protection of ACEI/ARB meds.

 

So until we get more definitive guidance that the risk of being on these meds exceeds their benefit, I recommend no changes for now.

 

The scientific community is doing a fabulous job of rapidly gathering critical data about Covid.  I’m monitoring everything closely and will let you know if my recommendation changes.