COVID-19 and arterial hypertension: Hypothesis or evidence?

J Clin Hypertens (Greenwich). 2020 Jul;22(7):1120-1126. doi: 10.1111/jch.13925. Epub 2020 Jul 6.


Investigations reported that hypertension, diabetes, and cardiovascular diseases were the most prevalent comorbidities among the patients with coronavirus disease 2019 (COVID-19). Hypertension appeared consistently as the most prevalent risk factors in COVID-19 patients. Some investigations speculated about the association between renin-angiotensin-aldosterone system (RAAS) and susceptibility to COVID-19, as well as the relationship between RAAS inhibitors and increased mortality in these patients. This raised concern about the potential association between hypertension (and its treatment) and propensity for COVID-19. There are only a few follow-up studies that investigated the impact of comorbidities on outcome in these patients with conflicting findings. Hypertension has been proven to be more prevalent in patients with an adverse outcome (admission in intensive care unit, use of mechanical ventilation, or death). So far, there is no study that demonstrated independent predictive value of hypertension on mortality in COVID-19 patients. There are many speculations about this coronavirus and its relation with different risk factors and underlying diseases. The aim of this review was to summarize the current knowledge about the relationship between hypertension and COVID-19 and the role of hypertension on outcome in these patients.

Keywords: cardiovascular disease; coronavirus; outcome; risk factors.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiotensin Receptor Antagonists / adverse effects
  • Angiotensin-Converting Enzyme Inhibitors / adverse effects
  • COVID-19 / epidemiology*
  • COVID-19 / mortality
  • COVID-19 / physiopathology*
  • COVID-19 / virology
  • Cardiovascular Diseases / epidemiology
  • Comorbidity
  • Diabetes Mellitus / epidemiology
  • Disease Susceptibility
  • Female
  • Hospitalization
  • Humans
  • Hypertension / drug therapy
  • Hypertension / epidemiology*
  • Intensive Care Units / statistics & numerical data
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Predictive Value of Tests
  • Prevalence
  • Renin-Angiotensin System / drug effects
  • Renin-Angiotensin System / immunology
  • Respiration, Artificial / statistics & numerical data
  • Risk Factors
  • SARS-CoV-2 / genetics*


  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors