TY - JOUR
T1 - Association of hypertension with mortality in patients hospitalised with COVID-19
AU - Bhatia, Kunwardeep S.
AU - Sritharan, Hari P.
AU - Ciofani, Jonathan
AU - Chia, Justin
AU - Allahwala, Usaid K.
AU - Chui, Karina
AU - Nour, Daniel
AU - Vasanthakumar, Sheran
AU - Khandadai, Dhanvee
AU - Jayadeva, Pavithra
AU - Bhagwandeen, Rohan
AU - Brieger, David
AU - Choong, Christopher
AU - Delaney, Anthony
AU - Dwivedi, Girish
AU - Harris, Benjamin
AU - Hillis, Graham
AU - Hudson, Bernard
AU - Javorski, George
AU - Jepson, Nigel
AU - Kanagaratnam, Logan
AU - Kotsiou, George
AU - Lee, Astin
AU - Lo, Sidney T.
AU - Macisaac, Andrew I.
AU - McQuillan, Brendan
AU - Ranasinghe, Isuru
AU - Walton, Antony
AU - Weaver, James
AU - Wilson, William
AU - Yong, Andy S. C.
AU - Zhu, John
AU - Van Gaal, William
AU - Kritharides, Leonard
AU - Chow, Clara K.
AU - Bhindi, Ravinay
N1 - Copyright the Author(s) 2021. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.
PY - 2021/12/7
Y1 - 2021/12/7
N2 - Objective To assess whether hypertension is an independent risk factor for mortality among patients hospitalised with COVID-19, and to evaluate the impact of ACE inhibitor and angiotensin receptor blocker (ARB) use on mortality in patients with a background of hypertension. Method This observational cohort study included all index hospitalisations with laboratory-proven COVID-19 aged ≥18 years across 21 Australian hospitals. Patients with suspected, but not laboratory-proven COVID-19, were excluded. Registry data were analysed for in-hospital mortality in patients with comorbidities including hypertension, and baseline treatment with ACE inhibitors or ARBs. Results 546 consecutive patients (62.9±19.8 years old, 51.8% male) hospitalised with COVID-19 were enrolled. In the multivariable model, significant predictors of mortality were age (adjusted OR (aOR) 1.09, 95% CI 1.07 to 1.12, p<0.001), heart failure or cardiomyopathy (aOR 2.71, 95% CI 1.13 to 6.53, p=0.026), chronic kidney disease (aOR 2.33, 95% CI 1.02 to 5.32, p=0.044) and chronic obstructive pulmonary disease (aOR 2.27, 95% CI 1.06 to 4.85, p=0.035). Hypertension was the most prevalent comorbidity (49.5%) but was not independently associated with increased mortality (aOR 0.92, 95% CI 0.48 to 1.77, p=0.81). Among patients with hypertension, ACE inhibitor (aOR 1.37, 95% CI 0.61 to 3.08, p=0.61) and ARB (aOR 0.64, 95% CI 0.27 to 1.49, p=0.30) use was not associated with mortality. Conclusions In patients hospitalised with COVID-19, pre-existing hypertension was the most prevalent comorbidity but was not independently associated with mortality. Similarly, the baseline use of ACE inhibitors or ARBs had no independent association with in-hospital mortality.
AB - Objective To assess whether hypertension is an independent risk factor for mortality among patients hospitalised with COVID-19, and to evaluate the impact of ACE inhibitor and angiotensin receptor blocker (ARB) use on mortality in patients with a background of hypertension. Method This observational cohort study included all index hospitalisations with laboratory-proven COVID-19 aged ≥18 years across 21 Australian hospitals. Patients with suspected, but not laboratory-proven COVID-19, were excluded. Registry data were analysed for in-hospital mortality in patients with comorbidities including hypertension, and baseline treatment with ACE inhibitors or ARBs. Results 546 consecutive patients (62.9±19.8 years old, 51.8% male) hospitalised with COVID-19 were enrolled. In the multivariable model, significant predictors of mortality were age (adjusted OR (aOR) 1.09, 95% CI 1.07 to 1.12, p<0.001), heart failure or cardiomyopathy (aOR 2.71, 95% CI 1.13 to 6.53, p=0.026), chronic kidney disease (aOR 2.33, 95% CI 1.02 to 5.32, p=0.044) and chronic obstructive pulmonary disease (aOR 2.27, 95% CI 1.06 to 4.85, p=0.035). Hypertension was the most prevalent comorbidity (49.5%) but was not independently associated with increased mortality (aOR 0.92, 95% CI 0.48 to 1.77, p=0.81). Among patients with hypertension, ACE inhibitor (aOR 1.37, 95% CI 0.61 to 3.08, p=0.61) and ARB (aOR 0.64, 95% CI 0.27 to 1.49, p=0.30) use was not associated with mortality. Conclusions In patients hospitalised with COVID-19, pre-existing hypertension was the most prevalent comorbidity but was not independently associated with mortality. Similarly, the baseline use of ACE inhibitors or ARBs had no independent association with in-hospital mortality.
KW - clinical
KW - COVID-19
KW - hypertension
KW - pharmacology
UR - http://www.scopus.com/inward/record.url?scp=85121267546&partnerID=8YFLogxK
U2 - 10.1136/openhrt-2021-001853
DO - 10.1136/openhrt-2021-001853
M3 - Article
C2 - 34876491
AN - SCOPUS:85121267546
SN - 2053-3624
VL - 8
SP - 1
EP - 7
JO - Open Heart
JF - Open Heart
IS - 2
M1 - e001853
ER -