{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T06:32:51Z","timestamp":1773297171276,"version":"3.50.1"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,11,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">There has been significant controversy about the effects of pre\u2010hospitalization use of renin\u2010angiotensin system (RAS) inhibitors on the prognosis of patients with hypertension and coronavirus disease 2019.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We retrospectively assessed 2297 hospitalized patients with coronavirus disease 2019 at Tongji Hospital in Wuhan, China, from January 10 to March 30, 2020; and identified 1182 patients with known hypertension on pre\u2010hospitalization therapy. We compared the baseline characteristics and in\u2010hospital mortality between patients with hypertension taking RAS inhibitors (n=355) versus non\u2010RAS inhibitors (n=827). Of the 1182 patients with hypertension (median age 68\u00a0years, 49.1% male), 12\/355 (3.4%) patients died in the RAS inhibitors group versus 95\/827 (11.5%) patients in the non\u2010RAS inhibitors group (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001). Adjusted hazard ratio for mortality was 0.28 (95% CI 0.15\u20130.52,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001) at 45\u00a0days in the RAS inhibitors group compared with non\u2010RAS inhibitors group. Similar findings were observed when patients taking angiotensin receptor blockers (n=289) or angiotensin\u2010converting enzyme inhibitors (n=66) were separately compared with non\u2010RAS inhibitors group. The RAS inhibitors group compared with non\u2010RAS inhibitors group had lower levels of C\u2010reactive protein (median 13.5 versus 24.4\u00a0pg\/mL;\n              <jats:italic>P<\/jats:italic>\n              =0.007) and interleukin\u20106 (median 6.0 versus 8.5\u00a0pg\/mL;\n              <jats:italic>P<\/jats:italic>\n              =0.026) on admission. The protective effect of RAS inhibitors on mortality was confirmed in a meta\u2010analysis of published data when our data were added to previous studies (odd ratio 0.44, 95% CI 0.29\u20130.65,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In a large single center retrospective analysis, we observed a protective effect of pre\u2010hospitalization use of RAS inhibitors on mortality in patients with hypertension and coronavirus disease 2019, which might be associated with reduced inflammatory response.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.017736","type":"journal-article","created":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T09:02:11Z","timestamp":1597741331000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Mortality and Pre\u2010Hospitalization Use of Renin\u2010Angiotensin System Inhibitors in Patients with Hypertension and Coronavirus Disease 2019 (COVID\u201019)"],"prefix":"10.1161","volume":"9","author":[{"given":"Chen","family":"Chen","sequence":"first","affiliation":[{"name":"Division of Cardiology Department of Internal Medicine, and Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Internal 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San Raffaele University Milano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5443-4312","authenticated-orcid":false,"given":"Javid J.","family":"Moslehi","sequence":"additional","affiliation":[{"name":"Cardio\u2010Oncology Program Department of Medicine Vanderbilt University Medical Center Nashville TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1676-5257","authenticated-orcid":false,"given":"Enrico","family":"Ammirati","sequence":"additional","affiliation":[{"name":"\"De Gasperis\" Cardio Center and Transplant Center ASST Grande Ospedale Metropolitano Niguarda Milano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9774-3980","authenticated-orcid":false,"given":"Dao Wen","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Internal Medicine, and Hubei Key Laboratory of Genetics 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