Discontinuation of Renin-Angiotensin System Inhibitors During the Early Stage of the COVID-19 Pandemic
© The Author(s) 2023. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com..
BACKGROUND: In March and April 2020, medical societies published statements recommending continued use of renin-angiotensin system (RAS) inhibitors despite theoretical concerns that these medications could increase COVID-19 severity. Determining if patients discontinued RAS inhibitors during the COVID-19 pandemic could inform responses to future public health emergencies.
METHODS: We analyzed claims data from US adults with health insurance in the Marketscan database. We identified patients who filled a RAS inhibitor and were persistent, defined by not having a ≥30-day gap without medication available, and high adherence, defined by having medication available on ≥80% of days, from March 2019 to February 2020. Among these patients, we estimated the proportion who discontinued their RAS inhibitor (i.e., had ≥30 consecutive days without a RAS inhibitor available to take) between March and August 2020. For comparison, we estimated the proportion of patients that discontinued a RAS inhibitor between March and August 2019 after being persistent with high adherence from March 2018 to February 2019.
RESULTS: Among 816,380 adults who were persistent and adherent to a RAS inhibitor from March 2019 to February 2020, 10.8% discontinued this medication between March and August 2020. Among 822,873 adults who were persistent and adherent to a RAS inhibitor from March 2018 to February 2019, 11.7% discontinued this medication between March and August 2019. The multivariable-adjusted relative risk for RAS inhibitor discontinuation in 2020 vs. 2019 was 0.94 (95% CI 0.93-0.95).
CONCLUSIONS: There was no evidence of an increase in RAS inhibitor discontinuation during the early stage of the COVID-19 pandemic.
| Errataetall: | |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:36 |
|---|---|
| Enthalten in: |
American journal of hypertension - 36(2023), 7 vom: 15. Juni, Seite 404-410 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Muntner, Paul [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 16.06.2023 Date Revised 25.03.2024 published: Print CommentIn: Am J Hypertens. 2023 Apr 03;:. - PMID 37010128 Citation Status MEDLINE |
|---|
| doi: |
10.1093/ajh/hpad027 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM354660047 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM354660047 | ||
| 003 | DE-627 | ||
| 005 | 20240325234150.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1093/ajh/hpad027 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1346.xml |
| 035 | |a (DE-627)NLM354660047 | ||
| 035 | |a (NLM)36960855 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Muntner, Paul |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Discontinuation of Renin-Angiotensin System Inhibitors During the Early Stage of the COVID-19 Pandemic |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 16.06.2023 | ||
| 500 | |a Date Revised 25.03.2024 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Am J Hypertens. 2023 Apr 03;:. - PMID 37010128 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com. | ||
| 520 | |a BACKGROUND: In March and April 2020, medical societies published statements recommending continued use of renin-angiotensin system (RAS) inhibitors despite theoretical concerns that these medications could increase COVID-19 severity. Determining if patients discontinued RAS inhibitors during the COVID-19 pandemic could inform responses to future public health emergencies | ||
| 520 | |a METHODS: We analyzed claims data from US adults with health insurance in the Marketscan database. We identified patients who filled a RAS inhibitor and were persistent, defined by not having a ≥30-day gap without medication available, and high adherence, defined by having medication available on ≥80% of days, from March 2019 to February 2020. Among these patients, we estimated the proportion who discontinued their RAS inhibitor (i.e., had ≥30 consecutive days without a RAS inhibitor available to take) between March and August 2020. For comparison, we estimated the proportion of patients that discontinued a RAS inhibitor between March and August 2019 after being persistent with high adherence from March 2018 to February 2019 | ||
| 520 | |a RESULTS: Among 816,380 adults who were persistent and adherent to a RAS inhibitor from March 2019 to February 2020, 10.8% discontinued this medication between March and August 2020. Among 822,873 adults who were persistent and adherent to a RAS inhibitor from March 2018 to February 2019, 11.7% discontinued this medication between March and August 2019. The multivariable-adjusted relative risk for RAS inhibitor discontinuation in 2020 vs. 2019 was 0.94 (95% CI 0.93-0.95) | ||
| 520 | |a CONCLUSIONS: There was no evidence of an increase in RAS inhibitor discontinuation during the early stage of the COVID-19 pandemic | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a 19 | |
| 650 | 4 | |a COVID | |
| 650 | 4 | |a angiotensin system inhibitors | |
| 650 | 4 | |a blood pressure | |
| 650 | 4 | |a hypertension | |
| 650 | 4 | |a renin | |
| 650 | 4 | |a treatment discontinuation | |
| 650 | 7 | |a Angiotensin-Converting Enzyme Inhibitors |2 NLM | |
| 650 | 7 | |a Antihypertensive Agents |2 NLM | |
| 650 | 7 | |a Enzyme Inhibitors |2 NLM | |
| 650 | 7 | |a Angiotensin Receptor Antagonists |2 NLM | |
| 700 | 1 | |a Foti, Kathryn |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Zhixin |e verfasserin |4 aut | |
| 700 | 1 | |a Alanaeme, Chibuike J |e verfasserin |4 aut | |
| 700 | 1 | |a Choi, Eunhee |e verfasserin |4 aut | |
| 700 | 1 | |a Bress, Adam P |e verfasserin |4 aut | |
| 700 | 1 | |a Shimbo, Daichi |e verfasserin |4 aut | |
| 700 | 1 | |a Kronish, Ian |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t American journal of hypertension |d 1988 |g 36(2023), 7 vom: 15. Juni, Seite 404-410 |w (DE-627)NLM012611670 |x 1941-7225 |7 nnns |
| 773 | 1 | 8 | |g volume:36 |g year:2023 |g number:7 |g day:15 |g month:06 |g pages:404-410 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1093/ajh/hpad027 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 36 |j 2023 |e 7 |b 15 |c 06 |h 404-410 | ||