About the Problem of Arterial Hypertension as a Risk Factor in the COVID-19 Pandemic Conditions and its Treatment (Literature Review)

Abstract

Context. In a pandemic caused by a coronavirus infection, a special risk group are the patients with cardiovascular disease, hypertension and diabetes mellitus in particular, which are the most common risk groups among the general population. The spread of coronavirus disease is particularly dangerous in terms of decompensation of chronic complications, specific damage to the cardiovascular system, especially in cases of severe infection and high risk of adverse outcomes in the above cohort of patients. The combination of coronavirus disease and cardiovascular disease poses additional difficulties in diagnosing, identifying, and prescribing appropriate therapy, including antihypertensive therapy. Therefore, it is important to address the possible risks and complications in people with hypertension and diabetes mellitus in the conditions of coronavirus disease COVID-19 and the features of the antihypertensive therapy prescription. Objective. To investigate the peculiarities of treatment of patients with arterial hypertension in the context of the COVID-19 pandemic, to analyze possible risks and complications based on the results of studying the literature. Materials and methods. Content analysis, methods of systemic and comparative results, as well as bibliosemantic evaluation of current research in the literature on the prescription of antihypertensive therapy in patients with hypertension and diabetes in the conditions of coronavirus COVID-19 were used. Sources of information were searched in scientometric medical databases, namely PubMedNCBI, Medline, Web of Science and Google Scholar, etc. by keywords: diabetes, hypertension, antihypertensive therapy, COVID-19, complications, cardiovascular risk. 174 scientific works in English, Ukrainian and Russian were analyzed and sources were selected, which contain questions about the risks of patients with hypertension and diabetes in the conditions of coronavirus disease, including those related to the appointment of antihypertensive therapy. Results. RAAS inhibitors, which provide better blood pressure control, may partially help to maintain the immune system imbalance in hypertension. In patients with hypertension during a viral infection, blood pressure levels and cardiovascular risk should be monitored. Conclusions. Constant monitoring of hemodynamic parameters, ECG and ECHO-CG – should be under the control according to the indications. The association of RAAS blockers (ACE inhibitors and ARBs) with an increased risk of infection in patients and worsening of COVID-19 has not been established so far, so patients with CVD should continue to take them. Patients who have survived coronavirus disease should be included in the medical rehabilitation programs for faster and better recovery of various systems, primarily respiratory and cardiovascular, as well as to improve quality of life and reduce the risk of disability.