Are two commonly used blood pressure medications associated with an increased or decreased risk of COVID-19?

Hypertension, High Blood Pressure, Heart Disease

Bottom Line:

Although the use of angiotensin-receptor blockers (ARBs) and angiotensin-converting enzyme (ACE) inhibitors are more frequent in patients with COVID-19 due to a higher burden of cardiovascular disease, there is no evidence showing that their use is associated with a higher or lower risk of developing COVID-19.


Mancia, G. et al. Renin–Angiotensin–Aldosterone System Blockers and the Risk of Covid-19. New England Journal of Medicine (2020).

Date Published:

1 May 2020


Angiotensin-converting enzyme 2 (ACE-2) is a protein found in our bodies that is used by coronaviruses to enter into our cells. Angiotensin-receptor blockers (ARBs) and angiotensin-converting-enzyme (ACE) inhibitors are two types of medications commonly used to treat high blood pressure, heart disease, and kidney disease. In addition, they also increase expression of ACE-2 in the body, which has led to the hypothesis that they could be associated with a modified susceptibility to COVID-19. To address this hypothesis, researchers in Italy collected and analyzed healthcare data of both healthy patients and patients with COVID-19 from regional healthcare databases in Lombardy. The results of their study showed that patients with COVID-19 had higher rates of ARB and ACE inhibitor use but also had higher rates of cardiovascular disease. More importantly, the use of ARB and ACE inhibitors was not associated with any increased or decreased risk of COVID-19. As a result, although ARB and ACE inhibitor use is more common in patients with COVID-19 due to higher rates of cardiovascular disease, the use of these medications does not change a person’s susceptibility to getting COVID-19.

Summary by: Louis Huynh