{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T04:40:14Z","timestamp":1773808814323,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,11,21]],"date-time":"2020-11-21T00:00:00Z","timestamp":1605916800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Hypertension"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>It remains uncertain whether the hypertension (HT) medications angiotensin\u2010converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) mitigate or exacerbate SARS\u2010CoV\u20102 infection. We evaluated the association of ACEi and ARB with severe coronavirus disease 19 (COVID\u201019) as defined by hospitalization or mortality among individuals diagnosed with COVID\u201019. We investigated whether these associations were modified by age, the simultaneous use of the diuretic thiazide, and the health conditions associated with medication use. In an observational study utilizing data from a Massachusetts group medical practice, we identified 1449 patients with a COVID\u201019 diagnosis. In our study, pre\u2010infection comorbidities including HT, cardiovascular disease, and diabetes were associated with increased risk of severe COVID\u201019. Risk was further elevated in patients under age 65 with these comorbidities or cancer. Twenty percent of those with severe COVID\u201019 compared to 9% with less severe COVID\u201019 used ACEi, 8% and 4%, respectively, used ARB. In propensity score\u2010matched analyses, use of neither ACEi (OR\u00a0=\u00a01.30, 95% CI 0.93 to 1.81) nor ARB (OR\u00a0=\u00a00.94, 95% CI 0.57 to 1.55) was associated with increased risk of severe COVID\u201019. Thiazide use did not modify this relationship. Beta blockers, calcium channel blockers, and anticoagulant medications were not associated with COVID\u201019 severity. In conclusion, cardiovascular\u2010related comorbidities were associated with severe COVID\u201019 outcomes, especially among patients under age 65. We found no substantial increased risk of severe COVID\u201019 among patients taking antihypertensive medications. Our findings support recommendations against discontinuing use of renin\u2013angiotensin system (RAS) inhibitors to prevent severe COVID\u201019.<\/jats:p>","DOI":"10.1111\/jch.14101","type":"journal-article","created":{"date-parts":[[2020,11,21]],"date-time":"2020-11-21T17:42:38Z","timestamp":1605980558000},"page":"21-27","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Hypertension, medications, and risk of severe COVID\u201019: A Massachusetts community\u2010based observational study"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4808-2503","authenticated-orcid":false,"given":"Ann Z.","family":"Bauer","sequence":"first","affiliation":[{"name":"Department of Public Health University of Massachusetts Lowell Lowell MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Gore","sequence":"additional","affiliation":[{"name":"Department of Public Health University of Massachusetts Lowell Lowell MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan R.","family":"Sama","sequence":"additional","affiliation":[{"name":"Department of Public Health University of Massachusetts Lowell Lowell MA USA"},{"name":"Reliant Medical Group, Inc Worcester MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Rosiello","sequence":"additional","affiliation":[{"name":"Reliant Medical Group, Inc Worcester MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence","family":"Garber","sequence":"additional","affiliation":[{"name":"Reliant Medical Group, Inc Worcester MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Devi","family":"Sundaresan","sequence":"additional","affiliation":[{"name":"Reliant Medical Group, Inc Worcester MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"McDonald","sequence":"additional","affiliation":[{"name":"Reliant Medical Group, Inc Worcester MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"Arruda","sequence":"additional","affiliation":[{"name":"Reliant Medical Group, Inc Worcester MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Kriebel","sequence":"additional","affiliation":[{"name":"Department of Public Health University of Massachusetts Lowell Lowell MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,11,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa329"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.6775"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2003138117"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bcp.2017.07.022"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajprenal.90488.2008"},{"key":"e_1_2_8_7_1","article-title":"Angiotensin\u2010converting enzyme inhibitors vs angiotensin II receptor blockers: a comparison of outcomes in patients with coronavirus disease 2019 (COVID\u201019)","volume":"26","author":"Kalra A","year":"2020","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(20)30116-8"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40885-020-00144-0"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ddr.21656"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.307708"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.1624"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1101\/2020.05.17.20104943"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31030-8"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jch.13948"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.1855"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jash.2007.10.005"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40292-017-0239-7"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpv067"},{"key":"e_1_2_8_20_1","unstructured":"Why Germany's coronavirus death rate is far lower than in other countries. 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