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

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, p = 0.0001), age tertiles (second and third tertiles, OR: 2.0 and 4.7, p = 0.0001), and Charlson Comorbidity Index scores (second and third tertiles, OR: 4.7 and 8.1, p = 0.0001), hypertension was significantly predictive of all-cause mortality when this comorbidity was treated with angiotensin-converting enzyme inhibitors (ACEIs) (OR: 1.6, p = 0.002) or other than renin-angiotensin-aldosterone blockers (OR: 1.3, p = 0.001) or angiotensin II receptor blockers (ARBs) (OR: 1.2, p = 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.


Rodilla, E.; Saura, A.; Jiménez, I.; Mendizábal, A.; Pineda-Cantero, A.; Lorenzo-Hernández, E.; Fidalgo-Montero, M.P.; López-Cuervo, J.F.; Gil-Sánchez, R.; Rabadán-Pejenaute, E.; Abella-Vázquez, L.; Giner-Galvañ, V.; Solís-Marquínez, M.N.; Boixeda, R.; Peña-Fernández, A.; Carrasco-Sánchez, F.J.; González-Moraleja, J.; Torres-Peña, J.D.; Guisado-Espartero, M.E.; Escobar-Sevilla, J.; Guzmán-García, M.; Martín-Escalante, M.D.; Martínez-González, Á.L.; Casas-Rojo, J.M.; Gómez-Huelgas, R.

 J. Clin. Med. 20209, 3136.

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