Evidence map›Paper›PMID 36960855›Full record

ArticleAmerican journal of hypertension2023

Discontinuation of Renin-Angiotensin System Inhibitors During the Early Stage of the COVID-19 Pandemic.

Paul Muntner, Kathryn Foti, Zhixin Wang, Chibuike J Alanaeme, Eunhee Choi, Adam P Bress, Daichi Shimbo, Ian Kronish

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of hypertension, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.8field-weighted citation impact, top 31% 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

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Paul MuntnerDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.ORCID 0000-0002-4711-5492
Kathryn FotiDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Zhixin WangDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Chibuike J AlanaemeDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Eunhee ChoiDepartment of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
Adam P BressDepartment of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA.
Daichi ShimboDepartment of Medicine, Columbia University Irving Medical Center, New York, New York, USA.ORCID 0000-0001-6302-8834
Ian KronishDepartment of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
University of Alabama at Birmingham · USColumbia University Irving Medical Center · USUniversity of Utah · US

Funding

Project 3-Community Health workers United to Reduce Colorectal cancer and CVD among people at Higher risk (CHURCH)P50MD017341 · NIMHD · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI TERRY, MARY BETH · 2021 to 2025
$23.9M
Implementing Remote Patient Monitoring to Improve Hypertension Control in a Primary Care NetworkR01HL152699 · NHLBI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI KRONISH, IAN MATTHEW · 2021 to 2025
$3.5M
NHLBI NIH HHS R01 HL152699NIMHD NIH HHS P50 MD017341
6 · The paper itself

Abstract

backgroundIn March and April 2020, medical societies published statements recommending continued use of renin-angiotensin system (RAS) inhibitors despite theoretical concerns that these medications could increase COVID-19 severity. Determining if patients discontinued RAS inhibitors during the COVID-19 pandemic could inform responses to future public health emergencies.

methodsWe analyzed claims data from US adults with health insurance in the Marketscan database. We identified patients who filled a RAS inhibitor and were persistent, defined by not having a ≥30-day gap without medication available, and high adherence, defined by having medication available on ≥80% of days, from March 2019 to February 2020. Among these patients, we estimated the proportion who discontinued their RAS inhibitor (i.e., had ≥30 consecutive days without a RAS inhibitor available to take) between March and August 2020. For comparison, we estimated the proportion of patients that discontinued a RAS inhibitor between March and August 2019 after being persistent with high adherence from March 2018 to February 2019.

resultsAmong 816,380 adults who were persistent and adherent to a RAS inhibitor from March 2019 to February 2020, 10.8% discontinued this medication between March and August 2020. Among 822,873 adults who were persistent and adherent to a RAS inhibitor from March 2018 to February 2019, 11.7% discontinued this medication between March and August 2019. The multivariable-adjusted relative risk for RAS inhibitor discontinuation in 2020 vs. 2019 was 0.94 (95% CI 0.93-0.95).

conclusionsThere was no evidence of an increase in RAS inhibitor discontinuation during the early stage of the COVID-19 pandemic.

Indexed as

COVID-19AdultAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAntihypertensive AgentsEnzyme InhibitorsHumansPandemicsRenin-Angiotensin SystemAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAntihypertensive AgentsEnzyme Inhibitors19angiotensin system inhibitorsblood pressureCOVIDhypertensionrenintreatment discontinuation

Identifiers

PMID36960855
PMCPMC10267613
OpenAlexW4360804703

What OpenQuestion holds

Textmetadata
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.