Association of Hypertension with All-Cause Mortality among Hospitalized Patients with COVID-19

• Main Authors: Enrique Rodilla, Alberto Saura, Iratxe Jiménez, Andrea Mendizábal, Araceli Pineda-Cantero, Elizabeth Lorenzo-Hernández, Maria del Pilar Fidalgo-Montero, Joaquín Fernandez López-Cuervo, Ricardo Gil-Sánchez, Elisa Rabadán-Pejenaute, Lucy Abella-Vázquez, Vicente Giner-Galvañ, Marta Nataya Solís-Marquínez, Ramon Boixeda, Andrés de la Peña-Fernández, Francisco Javier Carrasco-Sánchez, Julio González-Moraleja, José David Torres-Peña, María Esther Guisado-Espartero, Joaquín Escobar-Sevilla, Marcos Guzmán-García, María Dolores Martín-Escalante, Ángel Luis Martínez-González, José Manuel Casas-Rojo, Ricardo Gómez-Huelgas
• Format: Article
• Language: English
• Published: MDPI AG 2020-09-01
• Series: Journal of Clinical Medicine
• Subjects: hypertension; COVID-19; angiotensin-converting enzyme inhibitors (ACEIs); angiotensin II receptor blockers (ARBs); all-cause mortality
• Online Access: https://www.mdpi.com/2077-0383/9/10/3136

It is unclear to which extent the higher mortality associated with hypertension in the coronavirus disease (COVID-19) is due to its increased prevalence among older patients or to specific mechanisms. Cross-sectional, observational, retrospective multicenter study, analyzing 12226 patients who required hospital admission in 150 Spanish centers included in the nationwide SEMI-COVID-19 Network. We compared the clinical characteristics of survivors versus non-survivors. The mean age of the study population was 67.5 ± 16.1 years, 42.6% were women. Overall, 2630 (21.5%) subjects died. The most common comorbidity was hypertension (50.9%) followed by diabetes (19.1%), and atrial fibrillation (11.2%). Multivariate analysis showed that after adjusting for gender (males, OR: 1.5, <i>p</i> = 0.0001), age tertiles (second and third tertiles, OR: 2.0 and 4.7, <i>p</i> = 0.0001), and Charlson Comorbidity Index scores (second and third tertiles, OR: 4.7 and 8.1, <i>p</i> = 0.0001), hypertension was significantly predictive of all-cause mortality when this comorbidity was treated with angiotensin-converting enzyme inhibitors (ACEIs) (OR: 1.6, <i>p</i> = 0.002) or other than renin-angiotensin-aldosterone blockers (OR: 1.3, <i>p</i> = 0.001) or angiotensin II receptor blockers (ARBs) (OR: 1.2, <i>p</i> = 0.035). The preexisting condition of hypertension had an independent prognostic value for all-cause mortality in patients with COVID-19 who required hospitalization. ARBs showed a lower risk of lethality in hypertensive patients than other antihypertensive drugs.