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Ace Inhibitors & Coronavirus

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GJG99

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Relationship to Diabetes
Type 1
Hello, there seems to be mixed messages (surprise, surprise) on whether people diabetics on Ace Inhibitors are more at risk of catching a more severe dose of Coronavirus ( see link to Lancet article). I have been taking 5mg of Ramipril for years and was thinking of asking my GP to switch to a viable alternative if possible.
Does anyone have experiences of different prescribed medication for BP?

 
Ace inhibitors give me a persistent cough known as ace cough, and so I cannot take them. I take amlodipine, candesartan and propranolol. None of those seem to give me side effects.
 
Hello @GLG99
I also take Ramipril, so share your concerns. I subscribe to 'Blood Pressure UK' and received the following statement from them today. I'm still thinking through what to do about it.


If you’re taking ACE inhibitors or angiotensin receptor blockers (ARBs)


Some social media sites and newspapers have suggested that some commonly-used drugs including ACE inhibitors (which have names ending in ‘pril” e.g. ramipril, lisinopril, perindopril) and ARBs (which have names ending in ‘sartan’ e.g. losartan, candesartan, valsartan) may increase both the risk of infection and the severity of SARS-CoV2 (the virus causing coronavirus). This has led to some people with high blood pressure (hypertension) stopping their medication, which could lead to harmful consequences such as a decline in blood pressure control, heart failure or stroke.

These concerns about the safety of ACE inhibitors and ARBs in relation to coronavirus are speculated and, without a sound scientific basis to support them, we recommend that you should continue with your usual treatment – it is very important that your blood pressure remains controlled. We will update you if new evidence comes to light and this advice changes.

This recommendation is based on statements from The International Society of Hypertension (ISH), the Council on Hypertension of the European Society of Cardiology, and the European Society of Hypertension. It is not tailored to individuals so follow the advice of your doctor.

Note that this applies to patients taking these drugs for heart failure, high blood pressure, diabetes or kidney disease.
 
This is probably the reply I will get from my doctor tomorrow although it does concern me the Lancet published a paper on it. My BP is good so my question will fall on deaf ears. I will not stop the medication but I would like him to acknowledge the risk and suggest something different
 
Not sure if I'll be able to speak to my GP about this as I think surgery has closed, looking online.
 
The ACE inhibitors are the first choice for diabetics since they are also sposed to be kidney protective, and many diabetics are put on a low dose of them for starters only for preventative reasons. If however they have actual higher BP, develop a side effect or are otherwise advised to stop taking them, then an ARB will normally be prescribed instead,

Since I got the well known ACE cough, they swapped me to an ARB, however some years later I always got low serum sodium results whenever the GP or hospital did the full range of blood tests us lucky diabetics get at least annually. So by this time, I did have higher BP so needed a drug that would work. Many other BP drugs cause my feet and ankles to swell ridiculously, and when they do that cos that's common, they normally prescribe yet another drug a 'water tablet' to try and negate that. But with low sodium - that's contra indicated.
So I'm currently taking an alpha blocker which is OK mostly, though I still have somewhat puffy ankles and also far higher BP if I don't rest for long enough and also do the slow, deep breathing for long enough, before having it taken.

Far as I know just now, all GP surgeries can only be contacted by telephone at the moment and every single person will be triaged and then called back by a Dr or nurse if the info gleaned shows that the person needs it. That Dr or nurse then establishes whether they need to be seen and if so will arrange the required appointment.
 
Other than the cough (which I don't always notice, until now!) I don't think I have any side effects and I have taken quite happily for many years, its just with this bloody virus I am on a heightened sense of vigilance because know of us know how bad it good be for us.
 
My cough was every single night and I'd literally get no sleep at all some nights - we were in France at the start of a long holiday (couple or 3 months-ish) so I'd stopped taking them anyway before we came home, in order to enjoy our hol !
 
As expected, my Doctor said carrying on taking them, no scientific link between ACEs and Coronavirus proven. As my local surgery is virtually closed for face to face appointments, this looks like something that will have to wait
 
I have emailed my GP. Waiting to what she says. Prob same as you GJG.
 
Just received this reply from my GP

"Further to your query, There are no current guidelines to switch medications for any of diabetic or hypertensive medications. It has been advised for patients to continue on their current medications regime. This is important to keep chronic medical problems well controlled. If there is any change in guidelines then we will be in touch"

I did request a change of tablets but clearly they don't consider that necessary as things stand. I presume they would continue looking into this as things progress.
 
GJG99 said:
As expected, my Doctor said carrying on taking them, no scientific link between ACEs and Coronavirus proven. As my local surgery is virtually closed for face to face appointments, this looks like something that will have to wait
Click to expand...

Glad you’ve heard that response. That was exactly my understanding too.

Same as the scare about ibuprofen... a lot of added worry and anxiety spread about, with not much solid evidence that there is an actual problem. :(
 
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