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논문 기본 정보

자료유형
학술저널
저자정보
Kang Si-Hyuck (Cardiovascular Center Department of Internal Medicine Seoul National University Bundang Hospital Se) 이동훈 (서울대학교) Han Kyung-do (Department of Statistics and Actuarial Science Soongsil University) Jung Jin-Hyung (가톨릭대학교) Park Sang-Hyun (가톨릭대학교) Dai Andrew M. (Mountain View CA US) Wei Henry G. (Mountain View CA US) Yoon Chang-Hwan (Cardiovascular Center Department of Internal Medicine Seoul National University Bundang Hospital Se) 연태진 (서울대학교) 채인호 (서울대학교) 김철호 (서울대학교)
저널정보
대한고혈압학회 Clinical Hypertension Clinical Hypertension 제27권 제3호
발행연도
2021.7
수록면
18 - 24 (7page)
DOI
10.1186/s40885-021-00168-0

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Background: There have been concerns regarding the safety of renin-angiotensin-aldosterone-system (RAAS)- blocking agents including angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) during the coronavirus disease 2019 (COVID-19) pandemic. This study sought to evaluate the impact of hypertension and the use of ACEI/ARB on clinical severity in patients with COVID-19. Methods: A total of 3,788 patients aged 30 years or older who were confirmed with COVID-19 with real time reverse transcription polymerase chain reaction were identified from a claims-based cohort in Korea. The primary study outcome was severe clinical events, a composite of intensive care unit admission, need for ventilator care, and death. Results: Patients with hypertension (n = 1,190, 31.4 %) were older and had higher prevalence of comorbidities than those without hypertension. The risk of the primary study outcome was significantly higher in the hypertension group, even after multivariable adjustment (adjusted odds ratio [aOR], 1.67; 95 % confidence interval [CI], 1.04 to 2.69). Among 1,044 patients with hypertensive medical treatment, 782 (74.9 %) were on ACEI or ARB. The ACEI/ARB subgroup had a lower risk of severe clinical outcomes compared to the no ACEI/ARB group, but this did not remain significant after multivariable adjustment (aOR, 0.68; 95 % CI, 0.41 to 1.15). Conclusions: Patients with hypertension had worse COVID-19 outcomes than those without hypertension, while the use of RAAS-blocking agents was not associated with increased risk of any adverse study outcomes. The use of ACE inhibitors or ARBs did not increase the risk of adverse COVID-19 outcomes, supporting current guidance to continue these medications when indicated.

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