High blood pressure and its treatment not risk factors for worse Covid outcomes

High blood pressure and treatments to control it do not increase the risk of hospitalisation and death from Covid-19, according to a large European-wide study which in the UK was co-ordinated at UCLH and UCL.

The study, known as CAPACITY COVID and published in the Nature journal Hypertension Research, resolves a key question during the pandemic of whether hypertension and its treatment were linked to poorer outcomes from Covid. The findings should reassure patients on an issue that had caused a lot of anxiety

Hypertension had been consistently reported as an important risk factor for more severe disease and mortality in Covid-19 patients admitted to hospital.

However, in the study spanning 12 countries and over 9,000 patients, the research team found that when adjusted for age and other conditions linked to hypertension such as diabetes, obesity and advanced kidney disease, there is no link between high blood pressure and the risk of worse outcomes from Covid.

Similar analysis was done for hypertension treatments. Among patients in the study, the most common blood pressure lowering treatments were drugs known as angiotensin receptor blockers and angiotensin converting enzyme inhibitors. Analysis showed that rather than being linked with worse outcomes, both classes of drug were in fact associated with better outcomes.

CAPACITY-COVID (Cardiac complicAtions in Patients With SARS Corona vIrus 2 regisTrY) was set up to determine the role of cardiovascular disease in the Covid-19 pandemic. It is a British Heart Foundation/NIHR Flagship Covid project. Prof Folkert Asselbergs, Consultant Cardiologist at University Medical Center Utrecht, leads the study overall. The UK portion of the study is led by the BRC at UCLH and UCL.

BRC Director Professor Bryan Williams said: “This research shows the importance of large, well curated data sets that allow appropriate statistical analysis to adjust for factors that may lead commentators to the wrong conclusions. This is what happened in the case of high blood pressure and its treatment, neither of which are independent risk factors for poorer Covid outcomes in hospitalised patients.”

The study authors said the findings have important implications for public health messaging – and that patients should feel reassured that their high blood pressure and treatment for it do not on their own place them at greater risk should they develop Covid-19.

Read the paper: The impact of pre-existing hypertension and its treatment on outcomes in patients admitted to hospital with COVID-19