Could drugs currently approved to treat heart disease also prevent or reduce complications from COVID-19? That’s what researchers are currently investigating. Blood thinners, Blood pressure drugs, statins, and antiplatelets are all now under evaluation for their potential role in the fight against the coronavirus.
Experts Rethink Warnings About Dangers of Heart Drugs Amid Pandemic
Every time a person infected with SARS-CoV-2 coughs, virus droplets fly out of the mouth at up to 50 miles per hour. When another person unknowingly inhales those droplets, the coronavirus travels straight into the lungs. Once inside, the virus uses a spike protein to target ACE2 enzymes located on the surface of the airway’s cells.
If the spike protein successfully connects with an ACE2 enzyme, the coronavirus gains entry into the cell and triggers an infection. Based on this behavior, researchers hypothesized in the early days of the outbreak that a person’s vulnerability to infection was correlated to the number of ACE2 enzymes on their cells.
As a result, doctors announced an urgent warning in March to the millions of people taking blood pressure medications to control chronic conditions. At the time, angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) were believed to increase ACE2 levels in cells. Scientists were concerned that those taking heart drugs, especially those above the age of 60, could be more susceptible to COVID-19.
However, three months later, experts are rethinking their warning about ACE2’s role in the SARS-CoV-2 infection. It may not be as cut-and-dry as they once believed. Hundreds of studies have sought to explore the relationship between ACE2 and COVID-19 since the pandemic emerged. Now doctors and researchers believe that blood pressure medications and other heart drugs may actually have a protective effect against the coronavirus.
The Protective Role of Heart Drugs in Coronavirus Patients
It became clear to doctors in the first weeks of the COVID-19 pandemic that the elderly and those with certain chronic conditions faced a higher risk of severe infection. “The risk factors appeared to be hypertension, heart disease, or other cardiovascular disease,” says Paul Insel, a pharmacologist at the University of California, San Diego (UCSD).
However, going off hypertension and heart disease medications like ACEIs and ARBs ultimately created different problems. Studies show that while hypertensive patients do have a two-fold increased risk of dying from the coronavirus compared to patients without high blood pressure, the risk is even higher for hypertensive patients who stop taking their medications.
One study from Wuhan, China, for example, examined data from 2866 patients with COVID-19. Of those patients, 850 had a medical history of high blood pressure. 710 of those patients were being treated with medication and 140 were not. Overall 4% of the 850 hypertensive patients died compared to only 1.1% of the 2027 patients without hypertension.
But among the hypertensive patients themselves, only 3.2% of patients taking medication for high blood pressure died compared to the 7.9% of hypertensive patients not taking medication for the condition.
In light of a growing body of clinical evidence with similar results, experts now believe heart drugs could actually reduce the risk of severe COVID-19 infections and protect highly vulnerable patients. Clinical trials are still months away from providing more insight on this theory, but more than a dozen societies and associations, including the American Heart Association and International Society of Hypertension, have released statements encouraging people to continue taking their antihypertensive drugs, even if infected with the coronavirus.