Evidence map›Paper›PMID 33423528›Full record

Observational studyHypertension (Dallas, Tex. : 1979)2021

Antihypertensive Drugs and COVID-19 Risk: A Cohort Study of 2 Million Hypertensive Patients.

Laura Semenzato, Jérémie Botton, Jérôme Drouin, Bérangère Baricault, Clémentine Vabre, François Cuenot, Laetitia Penso, Philippe Herlemont, Emilie Sbidian, Alain Weill and 2 more

Open access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Hypertension (Dallas, Tex. : 1979), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
71citing papers in PubMed, 4 pooled it
7.3field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

71 citing papers in PubMed, 4 syntheses or guidelines pooled it, 116 citations in OpenAlex.

  1. Pooled it
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  10. The Bidirectional Association Between Metabolic Syndrome and Long-COVID-19.Diabetes, metabolic syndrome and obesity : targets and therapy · 2024
    Review
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  20. Journal of the American Heart Association · 2022
    Article

11 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 1 country.

Laura Semenzato *EPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products, Saint-Denis, France and the French National Health Insurance, Paris, France (L.S., J.B., B.B., C.V., J.D., F.C., L.P., P.H., E.S., A.W., R.D.-S., M.Z.).
Jérémie Botton *EPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products, Saint-Denis, France and the French National Health Insurance, Paris, France (L.S., J.B., B.B., C.V., J.D., F.C., L.P., P.H., E.S., A.W., R.D.-S., M.Z.).
Jérôme DrouinEPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products, Saint-Denis, France and the French National Health Insurance, Paris, France (L.S., J.B., B.B., C.V., J.D., F.C., L.P., P.H., E.S., A.W., R.D.-S., M.Z.).
Bérangère BaricaultEPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products, Saint-Denis, France and the French National Health Insurance, Paris, France (L.S., J.B., B.B., C.V., J.D., F.C., L.P., P.H., E.S., A.W., R.D.-S., M.Z.).
Clémentine VabreEPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products, Saint-Denis, France and the French National Health Insurance, Paris, France (L.S., J.B., B.B., C.V., J.D., F.C., L.P., P.H., E.S., A.W., R.D.-S., M.Z.).
François CuenotEPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products, Saint-Denis, France and the French National Health Insurance, Paris, France (L.S., J.B., B.B., C.V., J.D., F.C., L.P., P.H., E.S., A.W., R.D.-S., M.Z.).
Laetitia PensoEPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products, Saint-Denis, France and the French National Health Insurance, Paris, France (L.S., J.B., B.B., C.V., J.D., F.C., L.P., P.H., E.S., A.W., R.D.-S., M.Z.).
Philippe HerlemontEPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products, Saint-Denis, France and the French National Health Insurance, Paris, France (L.S., J.B., B.B., C.V., J.D., F.C., L.P., P.H., E.S., A.W., R.D.-S., M.Z.).
Emilie SbidianEpidemiology in Dermatology and Evaluation of Therapeutics Research Unit, University Paris-Est Créteil (E.S.).
Alain WeillEPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products, Saint-Denis, France and the French National Health Insurance, Paris, France (L.S., J.B., B.B., C.V., J.D., F.C., L.P., P.H., E.S., A.W., R.D.-S., M.Z.).
Rosemary Dray-SpiraEPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products, Saint-Denis, France and the French National Health Insurance, Paris, France (L.S., J.B., B.B., C.V., J.D., F.C., L.P., P.H., E.S., A.W., R.D.-S., M.Z.).
Mahmoud ZureikUniversity Paris-Saclay, UVSQ, University Paris-Sud, Inserm, Anti-Infective Evasion and Pharmacoepidemiology, CESP, 78180, Montigny le Bretonneux, France (M.Z.).
Agence Nationale de Sécurité Sanitaire de l’Alimentation, de l’Environnement et du Travail · FRInserm · FRUniversité Paris-Est Créteil · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

After initially hypothesizing a positive relationship between use of renin-angiotensin-aldosterone system inhibitors and risk of coronavirus disease 2019 (COVID-19), more recent evidence suggests negative associations. We examined whether COVID-19 risk differs according to antihypertensive drug class in patients treated by ACE (angiotensin-converting enzyme) inhibitors and angiotensin receptor blockers (ARBs) compared with calcium channel blockers (CCBs). Three exclusive cohorts of prevalent ACE inhibitors, ARB and CCB users, aged 18 to 80 years, from the French National Health Insurance databases were followed from February 15, 2020 to June 7, 2020. We excluded patients with a history of diabetes, known cardiovascular disease, chronic renal failure, or chronic respiratory disease during the previous 5 years, to only consider patients treated for uncomplicated hypertension and to limit indication bias. The primary end point was time to hospitalization for COVID-19. The secondary end point was time to intubation/death during a hospital stay for COVID-19. In a population of almost 2 million hypertensive patients (ACE inhibitors: 566 023; ARB: 958 227; CCB: 358 306) followed for 16 weeks, 2338 were hospitalized and 526 died or were intubated for COVID-19. ACE inhibitors and ARBs were associated with a lower risk of COVID-19 hospitalization compared with CCBs (hazard ratio, 0.74 [95% CI, 0.65-0.83] and 0.84 [0.76-0.93], respectively) and a lower risk of intubation/death. Risks were slightly lower for ACE inhibitor users than for ARB users. This large observational study may suggest a lower COVID-19 risk in hypertensive patients treated over a long period with ACE inhibitors or ARBs compared with CCBs. These results, if confirmed, tend to contradict previous hypotheses and raise new hypotheses.

Indexed as

PandemicsAdolescentAdultAgedAged, 80 and overAngiotensin-Converting Enzyme 2Angiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAntihypertensive AgentsCalcium Channel BlockersComorbidityCOVID-19Disease SusceptibilityDrug UtilizationFemaleFollow-Up StudiesACE2 protein, humanAngiotensin-Converting Enzyme 2Angiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAntihypertensive AgentsCalcium Channel BlockersReceptors, Virusangiotensin-converting enzyme inhibitorsangiotensin receptor blockerscalcium channel blockersCOVID-19hospitalizationmortalitypharmacoepidemiology

Identifiers

PMID33423528
PMCPMC7884243
OpenAlexW3120570797

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.