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Blood Pressure Drugs Don’t Increase Coronavirus Risk, Studies Find Blood Pressure Drugs Don’t Increase Coronavirus Risk, Studies Find
(about 1 month later)
Drugs that are widely prescribed to treat high blood pressure do not make patients more susceptible to coronavirus infection, or to severe illness if they do become infected, researchers reported on Friday.Drugs that are widely prescribed to treat high blood pressure do not make patients more susceptible to coronavirus infection, or to severe illness if they do become infected, researchers reported on Friday.
Their findings are good news for millions of people who take blood pressure drugs that belong to two classes: ACE inhibitors, which include lisinopril, captopril and other drugs with generic names ending in –pril; and ARBs, which include losartan, valsartan and other generic drugs ending in –sartan. Brand names for ACE inhibitors include Zestril and Prinivil; for ARBs, Cozaar and Atacand.Their findings are good news for millions of people who take blood pressure drugs that belong to two classes: ACE inhibitors, which include lisinopril, captopril and other drugs with generic names ending in –pril; and ARBs, which include losartan, valsartan and other generic drugs ending in –sartan. Brand names for ACE inhibitors include Zestril and Prinivil; for ARBs, Cozaar and Atacand.
Since the epidemic began, conflicting theories have circulated about whether those drugs could make the disease better or worse, or have any effect at all.Since the epidemic began, conflicting theories have circulated about whether those drugs could make the disease better or worse, or have any effect at all.
The new research was published Friday by The New England Journal of Medicine, and similar findings from China were published last week in JAMA Cardiology.The new research was published Friday by The New England Journal of Medicine, and similar findings from China were published last week in JAMA Cardiology.
The U.S. study also found no risk linked to three other classes of commonly used blood pressure drugs — beta blockers, calcium-channel blockers and thiazide diuretics.The U.S. study also found no risk linked to three other classes of commonly used blood pressure drugs — beta blockers, calcium-channel blockers and thiazide diuretics.
Both studies were based on reviewing patients’ records, which does not provide evidence as strong as the results of controlled clinical trials, where patients are picked at random to take one treatment or another.Both studies were based on reviewing patients’ records, which does not provide evidence as strong as the results of controlled clinical trials, where patients are picked at random to take one treatment or another.
Concerns arose about the drugs early in the epidemic when reports from China indicated that people with hypertension seemed to fare poorly, and it seemed logical to investigate if the cause was the condition itself or if blood pressure drugs were somehow making patients more vulnerable.Concerns arose about the drugs early in the epidemic when reports from China indicated that people with hypertension seemed to fare poorly, and it seemed logical to investigate if the cause was the condition itself or if blood pressure drugs were somehow making patients more vulnerable.
In addition, studies in animals had shown that ARBSs and ACE inhibitors could increase the levels in some tissue of a protein called ACE2, which happens to be the substance that the virus grabs onto as it invades cells. In theory, higher levels of that protein in the lungs might help the virus attack by acting as extra handholds, some scientists have warned. But it is not known whether the drugs actually raise ACE2 in human lungs.In addition, studies in animals had shown that ARBSs and ACE inhibitors could increase the levels in some tissue of a protein called ACE2, which happens to be the substance that the virus grabs onto as it invades cells. In theory, higher levels of that protein in the lungs might help the virus attack by acting as extra handholds, some scientists have warned. But it is not known whether the drugs actually raise ACE2 in human lungs.
Confounding the matter was evidence from animal studies that suggested the opposite effect: The drugs might quell inflammation in the lungs and lower the risk of severe disease in coronavirus patients. A controlled trial is about to begin to find out if ACE inhibitors can help Covid-19 patients, the University of California San Diego School of Medicine announced on Thursday.Confounding the matter was evidence from animal studies that suggested the opposite effect: The drugs might quell inflammation in the lungs and lower the risk of severe disease in coronavirus patients. A controlled trial is about to begin to find out if ACE inhibitors can help Covid-19 patients, the University of California San Diego School of Medicine announced on Thursday.
Not surprisingly, patients have been confused and unsettled. Medical societies have urged calm, saying that people should stick with their medications because high blood pressure increases the risks of heart disease, strokes and kidney damage. But the societies also called for research into the issue, and the fears have lingered.Not surprisingly, patients have been confused and unsettled. Medical societies have urged calm, saying that people should stick with their medications because high blood pressure increases the risks of heart disease, strokes and kidney damage. But the societies also called for research into the issue, and the fears have lingered.
“I worry because I’ve received calls from many patients asking if they should stop their medicine or switch to something else, and some even stopped their medications without asking me,” Dr. Harmony Reynolds, the associate director of the cardiovascular research center at the New York University Grossman School of Medicine, said in an interview.“I worry because I’ve received calls from many patients asking if they should stop their medicine or switch to something else, and some even stopped their medications without asking me,” Dr. Harmony Reynolds, the associate director of the cardiovascular research center at the New York University Grossman School of Medicine, said in an interview.
Updated June 5, 2020
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Some who check their blood pressure at home tell her it is going up, and she is not sure whether the cause is stress from the pandemic, lack of exercise, changes in their eating habits or avoidance of the drugs.Some who check their blood pressure at home tell her it is going up, and she is not sure whether the cause is stress from the pandemic, lack of exercise, changes in their eating habits or avoidance of the drugs.
To address the problem, Dr. Reynolds led a team that analyzed the records of 12,594 people who were tested for the coronavirus, including 5,894 who were infected. Some also had high blood pressure. The goal was to determine whether coronavirus infection or severe illness were more common in people taking the blood pressure drugs.To address the problem, Dr. Reynolds led a team that analyzed the records of 12,594 people who were tested for the coronavirus, including 5,894 who were infected. Some also had high blood pressure. The goal was to determine whether coronavirus infection or severe illness were more common in people taking the blood pressure drugs.
The researchers looked at the patients’ likelihood of being infected, the severity of the illness and the drugs that they were taking before being tested for the virus. They used statistical methods to rule out differences that might be due to age, sex, race, ethnicity, smoking history and other factors. If a blood pressure drug was associated with a difference of more than 10 percent in the risk of being infected or becoming severely ill, they considered that difference “clinically meaningful.”The researchers looked at the patients’ likelihood of being infected, the severity of the illness and the drugs that they were taking before being tested for the virus. They used statistical methods to rule out differences that might be due to age, sex, race, ethnicity, smoking history and other factors. If a blood pressure drug was associated with a difference of more than 10 percent in the risk of being infected or becoming severely ill, they considered that difference “clinically meaningful.”
No meaningful differences emerged.No meaningful differences emerged.
“The main message here is that there is no signal of increased risk, and that should be very reassuring,” Dr. Reynolds said.“The main message here is that there is no signal of increased risk, and that should be very reassuring,” Dr. Reynolds said.