COVID-19 and Antihypertensive Treatment

This chapter reviews the evidence that hypertension increases the risk of severe COVID-19 infection and argues in favor of the possibility that this is due to the high prevalence of hypertension-related organ damage in the population. It also reports the results of large-scale observational studies and of the available small trials that pretreatment with or intra-infection use of blockers of the renin-angiotensin system does not modify the risk and severity of COVID-19 and that this is likely to be true also for other antihypertensive drugs. Finally, the chapter addresses the multiple factors that during the COVID-19 pandemic and related lockdowns may have increased blood pressure and reduced blood pressure control of hypertensive patients, including disruption of healthcare systems’ ability to cope with diseases other than COVID-19. Some suggestions for hypertension guidelines modifications are issued.