Antihypertensive profile in COVID-19 patients at emergency field hospital Surabaya, Indonesia
DOI:
https://doi.org/10.46542/pe.2024.243.315321Keywords:
Antihypertensive drug, Covid-19, Hypertension, Length of stayAbstract
Background: Case fatality rates for COVID-19 patients with hypertension have reached up to 14%. Using ACEi and ARB reduces ACE and increases ACE2 expression, which theoretically can mediate SARS-CoV-2 invasion and infection.
Objective: This study examines the profile of hypertension therapy, time to reduce blood pressure, and length of stay.
Method: A retrospective cross-sectional observational study was undertaken. Data were collected from patients' medical records using a consecutive and time-limited sampling method.
Result: 222 patients were involved in this study. The most widely used antihypertensive monotherapy is oral amlodipine (1x5 mg) 51.35%, and combination therapy with oral amlodipine (1x10 mg) plus candesartan (1x8 mg) 8.11%. The mean time to reduce blood pressure was 5.96 and 6.67 days, and the mean length of stay was 5.99 and 6.67 days. Correlation analysis on the rate of decrease in blood pressure with length of stay showed significance (p = 0.000 < 0.05) with a positive Spearman correlation (0.992), which showed a very strong correlation.
Conclusion: Antihypertensive therapy in this study was following existing guidelines. The time to reduce blood pressure was proportional to the length of stay, so hypertension is vital to control to support the improvement of the patient's clinical condition.
References
Chen, R., Yang, J., Gao, X., Ding, X., Yang, Y., Shen, Y., He, C., Xiang, H., Ke, J., Yuan, F., Cheng, R., Lv, H., Li, P., Zhang, L., Liu, C., Tan, H., & Huang, L. (2020). Influence of blood pressure control and application of renin-angiotensin-aldosterone system inhibitors on outcomes in COVID-19 patients with COVID-19 hypertension. Journal of Clinical Hypertension, 22(11), 1974–1983. https://doi.org/10.1111/jch.14038
Clark, C. E., McDonagh, S. T. J., McMaleus, R. J., & Martin, U. (2021). COVID-19 and hypertension: Risks and management. A scientific statement on behalf of the British and Irish Hypertension Society. Journal of Human Hypertension, 35(4), 304–307. https://doi.org/10.1038/s41371-020-00451-x
Guan, W., Ni, Z., Hu, Y., Liang, W., Ou, C., He, J., Zhong, N. (2020). Clinical characteristics of Coronavirus disease 2019 in China. New England Journal of Medicine, 382(18), 1708–1720. https://doi.org/10.1056/NEJMoa2002032
Huang, S., Wang, J., Liu, F., Liu, J., Cao, G., Yang, C., Liu, W., Tu, C., Zhu, M., & Xiong, B. (2020). COVID-19 patients with hypertension have more severe disease: A multicenter retrospective observational study. The Japanese Society of Hypertension, 43(8), 824–831. https://doi.org/10.1038/s41440-020-0485-2
Indonesian Association of Cardiovascular Specialists. (2020). Guide to diagnosis and management of cardiovascular diseases during the Covid-19 pandemic. Indonesian Association of Cardiovascular Specialists.
James, P. A., Oparil, S., Carter, B. L., Cushmale, W. C., Dennison-Himmelfarb, C., Handler, J., Lackland, D. T., LeFevre, M. L., MacKenzie, T. D., Ogedegbe, O., Smith, S. C., Jr, Svetkey, L. P., Taler, S. J., Townsend, R. R., Wright, J. T., Jr, Narva, A. S., & Ortiz, E. (2014). 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). Journal of the American Medical Association, 311(5), 507–520. https://doi.org/10.1001/jama.2013.284427
Jin, J. M., Bai, P., He, W., Wu, F., Liu, X. F., Han, D. M., Liu, S., & Yang, J. K. (2020). Gender differences in patients with COVID-19: Focus on severity and mortality. Frontiers in Public Health, 8, 152‒157. https://doi.org/10.3389/fpubh.2020.00152
Kai, H., & Kai, M. (2020). Interactions of coronaviruses with ACE2, angiotensin II, and RAS inhibitors-lessons from available evidence and insights into COVID-19. The Japanese Society of Hypertension, 43(7), 648–654. https://doi.org/10.1038/s41440-020-0455-8
Kario, K., Morisawa, Y., Sukonthasarn, A., Turana, Y., Chia, Y. C., Park, S., Wang, T. D., Chen, C. H., Tay, J. C., Li, Y., & Wang, J. G. (2020). COVID-19 and hypertension evidence and practical management: Guidance from the HOPE Asia Network. Journal of Clinical Hypertension, 22(7), 1109–1119. https://doi.org/10.1111/jch.13917
Lai, C. C., Shih, T. P., Ko, W. C., Tang, H. J., & Hsueh, P. R. (2020). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. International Journal of Antimicrobial Agents, 55(3), 1–10. https://doi.org/10.1016/j.ijantimicag.2020.105924
Ministry of Health of the Republic of Indonesia. (2023). Ministry of Health Emerging Infections. https://infeksiemerging.kemkes.go.id/dashboard/COVID-19
Pristianty, L., Priyandani, Y., & Rahem, A. (2023). The correlation between knowledge, attitude and family support on compliance of outpatients with hypertension in a healthcare centre in Indonesia. Pharmacy Education, 23(2), 25–30. https://doi.org/10.46542/pe.2023.232.2530
Williams, B., Malecia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M., Clement, D. L., Coca, A., de Simone, G., Dominiczak, A., Kahan, T., Mahfoud, F., Redon, J., Ruilope, L., Zanchetti, A., Kerins, M., Kjeldsen, S. E., Kreutz, R., Laurent, S., Lip, G. Y. H., McManus, R., Markiewicz, K., Ruschitzka F., Schmiede, R. E., Shlyakhto, E., Tsioufis, C., Aboyans, V., Desormais, I., & ESC Scientific Document Group. (2018). 2018 ESC/ESH guidelines for the management of arterial hypertension. European Heart Journal, 39(33), 3021–3104. https://doi.org/10.1093/eurheartj/ehy339
World Health Organisation. (2023). WHO coronavirus (COVID-19). https://covid19.who.int
Riyadina, Woro. (2019). Hypertension in Menopausal Women. Ministry of Health of the Republic of Indonesia.
Wu, S., Xue, L., Legido-Quigley, H., Khan, M., Wu, H., Peng, X., Li, X., & Li, P. (2020). Understanding factors influencing the length of hospital stay among non-severe COVID-19 patients: A retrospective cohort study in a Fangcang shelter hospital. PloS one, 15(10), 1‒14. https://doi.org/10.1371/journal.pone.0240959
Yang, G., Tan, Z., Zhou, L., Yang, M., Peng, L., Liu, J., Cai, J., Yang, R., Han, J., Huang, Y., & He, S. (2020). Effects of angiotensin II receptor blockers and ACE (Angiotensin-Converting Enzyme) inhibitors on virus infection, inflammatory status, and clinical outcomes in patients with COVID-19 and hypertension: A single-center retrospective study. American Heart Association, 76(1), 51–58. https://doi.org/10.1161/hypertensionaha.120.15143
Zhang, L. K., Sun, Y., Zeng, H., Wang, Q., Jiang, X., Shang, W. J., Wu, Y., Li, S., Zhang, Y. L., Hao, Z. N., Chen, H., Jin, R., Liu, W., Li, H., Peng, K., & Xiao, G. (2020). Calcium channel blocker amlodipine besylate therapy is associated with reduced case fatality rate of COVID-19 patients with hypertension. Cell Discovery, 6(1), 1‒2. https://doi.org/10.1038/s41421-020-00235-0
Zhou, X., Zhu, J., & Xu, T. (2020). Clinical characteristics of coronavirus disease 2019 (COVID-19) patients with hypertension on renin-angiotensin system inhibitors. Taylor & Francis, 42(7), 656–660. https://doi.org/10.1080/10641963.2020.1764018