Risk factors

Australian study to monitor outcomes with ACEi/ARBs in COVID-19

Prof. Alta Schutte

An Australian study is aiming assess the impact continuing versus discontinuing renin angiotensin system blockade on the risk of SARS-CoV-2 infection in patients with uncomplicated hypertension.

Led by Professor Alta Schutte  from the George Institute of Global Health in NSW, the study is looking to  recruit over 5,500 participants to investigate the possible effect of the drugs on infection COVID-19 via the ACE2 receptor mechanism

Supported by The Institute’s Professors Anthony Rogers, David Peiris and Bruce Neal – the study hopes to identify whether ACE inhibitor or angiotensin receptor blocker (ACEi/ARB) therapy should be continued or discontinued in patients with hypertension that become infected with COVID-19.

“There is a much-debated possibility that these commonly used hypertension therapies may modify the risk of COVID-19 infection in patients with hypertension and may also change the severity of disease in those affected,” the Institute said  in a statement.

“The results of this trial will be applicable to the hundreds of millions of people using ACEi/ARB therapy worldwide, with immediate implications for care and are anticipated to result in clinical guideline updates all around the world.”

The ACEi/ARB study is being supported by the Institute’s ‘Count Me In’: a national research register of one million Australians involved in COVID-19 research.

Meanwhile in a review published this week in the MJA, cardiologist Professor Garry Jennings of the University of Sydney said there was highly circumstantial arguments either way

with ACE inhibitors or ARBs, but nothing to justify stopping or changing therapy.

“As this issue has been wisely canvassed in the public media, health professionals will need to have a conversation with patients about the benefits or otherwise of continuing their present therapies,” he wrote.

“In recommending continuation of ACE-I or ARBs physicians can draw comfort that they are backed by almost every authoritative cardiovascular health authority in the world. Nevertheless, the clinical trial results cannot come quickly enough and in the best case they will allow us to turn practice into the right theory.”

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