Sex Differences in Association Between Anti-Hypertensive Medications and Risk of COVID-19 in Middle-Aged and Older Adults
Ma et al.
, Sex Differences in Association Between Anti-Hypertensive Medications and Risk of COVID-19 in Middle-Aged and..
, Drugs & Aging, doi:10.1007/s40266-021-00886-y
UK Biobank retrospective 77,271 patients aged 50-86, showing no significant differences with aspirin use. Matching lead to different results for the gender vs. overall analysis, for example the overall result for cases was OR 1.07, however both gender results are lower OR 0.97 and 1.02.
risk of death, 9.0% lower, OR 0.91, p = 0.12, treatment 12,471, control 64,750, RR approximated with OR.
risk of hospitalization, 2.0% lower, OR 0.98, p = 0.47, treatment 12,471, control 64,750, RR approximated with OR.
risk of symptomatic case, 9.0% higher, OR 1.09, p = 0.18, treatment 12,471, control 64,750, RR approximated with OR.
risk of case, 7.0% higher, OR 1.07, p = 0.09, treatment 12,471, control 64,750, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Ma et al., 18 Aug 2021, retrospective, propensity score matching, United Kingdom, peer-reviewed, 9 authors.
Abstract: Drugs & Aging
ORIGINAL RESEARCH ARTICLE
Sex Differences in Association Between Anti‑Hypertensive Medications
and Risk of COVID‑19 in Middle‑Aged and Older Adults
Yue Ma1 · Yuan Zhang1 · Shu Li1 · Hongxi Yang1 · Huiping Li1 · Zhi Cao1,2 · Fusheng Xu1 · Li Sun1,3 · Yaogang Wang1
Accepted: 8 July 2021
© The Author(s), under exclusive licence to Springer Nature Switzerland AG 2021
Background There is ongoing debate about the associations between drug therapies targeting the renin–angiotensin–aldosterone system (RAAS) and adverse outcomes in coronavirus disease 2019 (COVID-19).
Objective This study aims to examine the associations between using medications for the cardiovascular system and the
risks associated with COVID-19 in middle-aged and older adults.
Methods A total of 77,221 participants (aged 50–86 years) from UK Biobank were tested for SARS-CoV-2 RNA. The
medications included angiotensin-converting enzyme inhibitors (ACEI), angiotensin-receptor blockers (ARB), β-blockers,
calcium channel blockers (CCB), statins, and aspirin. COVID-19 outcomes comprised a positive test result and severity of
COVID-19 (defined as mild, hospitalization or death). We evaluated the risk among total participants and for sub-groups
based on sex. Propensity score matching was performed 1:1 and logistic regression models were used.
Results Among the middle- and older aged participants, no significant associations between any class of medications and
the likelihood of COVID-19 infection were observed. ACEI were associated with a higher mortality risk from COVID-19
(odds ratio [OR] 1.15, 95% confidence interval [CI] 1.01–1.32) and CCB were associated with a lower hospitalization risk
for COVID-19 (OR 0.87, 95% CI 0.79–0.96) among the male patients with COVID-19, while a lower mortality risk from
COVID-19 (OR 0.67, 95% CI 0.47–0.96) was observed with ARB among the female patients with COVID-19.
Conclusions The study suggested sex differences in the risk of death from COVID-19 with the use of ACEI and ARB among
middle-aged and older adults. Sex differences in the risk of hospitalization for COVID-19 with the use of CCB was observed
as well. It is of clinical importance that clinicians adopt different CVD treatment approaches for female and male patients
It is important to determine sex differences in the association between using renin–angiotensin–aldosterone
system (RAAS) inhibitors and the risks of COVID-19.
Sex differences in the association between RAAS inhibitors and risks of COVID-19 may be stronger at older
* Yaogang Wang
School of Public Health, Tianjin Medical University,
Tianjin 300070, China
Department of Epidemiology and Health Statistics, School
of Public Health, Zhejiang University, Hangzhou, China
School of Nursing, Tianjin Medical University, Tianjin,
There was a potential mortality risk for male patients
with COVID-19 in using angiotensin-converting enzyme
inhibitors and a protective effect of using calcium channel blockers. For female patients with COVID-19, using
angiotensin-receptor blockers was associated with a
lower risk of COVID-19 mortality.
Y. Ma et al.
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