Heart Groups: Patients with COVID-19 Should Continue ACE Inhibitors & ARBs

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

Patients with novel coronavirus disease (COVID-19) who have underlying hypertension, heart failure, or ischemic heart disease should not stop taking their angiotensin-converting-enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs), according to a new statement from the American Heart Association, the American College of Cardiology, and the Heart Failure Society of America.

In a correspondence in the Lancet Respiratory Medicine, researchers proposed that ACE-inhibitors and ARBs could increase the risk for developing severe COVID-19. The coronavirus binds to target cells through ACE 2, the expression of which is increased when patients take these drugs.

Dr. Karol Watson, associate editor with NEJM Journal Watch Cardiology, comments: "Some have suggested that utilization of renin–angiotensin–aldosterone system blockers may increase the ability of the virus to enter lungs, although there is no clinical data to support that this is actually true. This current statement should give clinicians comfort to continue use of RAAS blockers during these strange and unsettling times."