Renin-Angiotensin System Inhibition in Cardiovascular Patients at the Time of COVID19: Much Ado for Nothing? A Statement of Activity from the Directors of the Board and the Scientific Directors of the Italian Society of Hypertension

High Blood Press Cardiovasc Prev. 2020 Apr;27(2):105-108. doi: 10.1007/s40292-020-00380-3. Epub 2020 Apr 7.


Cardiovascular diseases, in particular hypertension, as well as the cardiovascular treatment with Renin-Angiotensin System inhibitors such as Angiotensin Converting Enzyme (ACE) inhibitors and Angiotensin Receptor Blockers (ARBs), are claimed once again as mechanisms of Severe Acute Respiratory Syndrome (SARS) during the COVID-19 outbreak due to Cov-2 epidemics. In vitro studies are available to support the eventual role of ACE inhibitors and ARBs in both the promotion and antagonism of the disease. The available literature, indeed, presents contrasting results, all concentrated in experimental models. Evidence in humans is lacking that those mechanisms are actually occurring in the present COVID-19 outbreak. Here we present the reasoned statement of the Italian Society of Hypertension to maintain ongoing antihypertensive treatments. Furthermore, the Italian Society of Hypertension presents its own initiative to investigate the issue using an online questionnaire to collect relevant data in human disease.

Keywords: COVID-19; cardiovascular diseases; hypertension; infection; outcomes.

Publication types

  • Practice Guideline

MeSH terms

  • Angiotensin Receptor Antagonists* / adverse effects
  • Angiotensin Receptor Antagonists* / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors* / adverse effects
  • Angiotensin-Converting Enzyme Inhibitors* / therapeutic use
  • Antihypertensive Agents* / adverse effects
  • Antihypertensive Agents* / therapeutic use
  • Betacoronavirus
  • COVID-19
  • Cardiovascular Diseases / complications
  • Coronavirus Infections* / complications
  • Humans
  • Hypertension / complications
  • Hypertension / drug therapy*
  • Italy
  • Pandemics*
  • Pneumonia, Viral* / complications
  • Renin-Angiotensin System* / drug effects
  • SARS-CoV-2


  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Antihypertensive Agents