Understanding the Complex Relationship between Hypertension, Antihypertensive Treatment, and COVID-19
Unraveling the Connection: Hypertension and COVID-19
Recent studies have highlighted a complex and multifaceted relationship between hypertension and the novel coronavirus or COVID-19. The systemic vascular damage, as well as shared pathophysiology between the two conditions, have been under intense scrutiny. This relationship is not merely limited to the risk factors but also extends to the impact of antihypertensive treatment on the severity of COVID-19.
The Role of Antihypertensive Medication
Antihypertensive treatment, specifically including ACE inhibitors, ARBs, and CCBs, have shown a significant association with COVID-19 severity. However, the findings have been contrasting. Some studies suggest that the use of certain antihypertensive drugs may lower the risk of in-hospital death and long COVID, particularly in women. On the other hand, COVID-19 has been found to cause a drop in blood pressure, leading to hypotension in hypertensive patients. This has led to a scenario where the therapy for hypertensive patients diagnosed with COVID-19 becomes too intensive.
Moreover, the efficacy of antihypertensive therapy has also been found to vary depending upon the type of drug in the renin-angiotensin system (RAS) group. It has been observed that hypertensive patients, who were on chronic RAS inhibitors and later contracted COVID-19, experienced hypotension, with a decrease in glomerular filtration rate and an increase in albuminuria.
CCBs: A Potential Therapeutic Option?
Among the various antihypertensive drugs, Calcium Channel Blockers (CCBs) have been singled out for their potential therapeutic effects on COVID-19 prognosis. However, these findings are still preliminary, and more rigorous and extensive investigation is needed to establish the therapeutic potential of CCBs in COVID-19 treatment and to clarify the overall effects of antihypertensive drugs on COVID-19 prognosis and long COVID.
COVID-19 and its Impact on the Environment
The pandemic has not only disrupted human health but has also left its imprint on the environment. A study from Wuhan, China indicates significant increases in antihypertensive and diabetic drugs in surface water during the pandemic. This was possibly due to an increased usage of these drugs owing to the increased prevalence of comorbidities and mental shock during the pandemic. There was also an increase in cotinine, likely related to increased smoking. These findings underscore the importance of monitoring the fate of pharmaceuticals in the aquatic environment and improving removal efficiencies in wastewater treatment plants.
Conclusion: An Evolving Understanding
The interplay between hypertension, antihypertensive treatment, and COVID-19 is an evolving area of research with significant implications for patient management and public health. The potential effects of antihypertensive medication on COVID-19 prognosis, the therapeutic potential of CCBs, and the environmental impacts of increased pharmaceutical use during the pandemic all warrant further investigation.