Patients who have taken valsartan blood pressure medication may be at a higher risk of complications due to the coronavirus.

Scientists recently revealed that ACE inhibitors and angiotensin receptor blockers, two popular drug classes used for treating high blood pressure and diabetes, may increase the risk of coronavirus complications.

The coronavirus, formally known as “2019 novel coronavirus,” “2019-nCoV,” or COVID-19, is at the center of a recent global pandemic. The virus is part of the coronavirus family – a group of pneumonia-causing viruses that includes former deadly viruses such as SARS and MERS.

Unfortunately, certain groups may be at a higher risk for dangerous coronavirus complications which can lead to death. According to the government’s coronavirus website, at risk groups include:

• People over the age of 65
• People living in a nursing home or long term care facility
• People with chronic conditions including:
  • Chronic lung disease
  • Moderate to severe asthma
  • Heart disease
  • Severe obesity
  • Diabetes
  • Renal failure
  • Liver disease
• People who are immunocompromised from a condition, medication, or cancer treatment
• People who are pregnant

Although pre-existing conditions may increase the risk of developing coronavirus complications, taking certain medications may also increase the risks.

Researchers from University Hospital Basel in Switzerland and the University of Thessaloniki in Greece recently published a research letter in The Lancet Respiratory Medicine journal, warning that angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) may increase coronavirus complication risks.

The researchers explained that these drugs, which can be prescribed to treat high blood pressure or diabetes, may change receptors found on upper respiratory cells in a way that makes them easier for COVID-19 to infect.

In addition to the risks associated with simply having high blood pressure or diabetes, the researchers argue that these cellular changes cause the medications to “facilitate infection with COVID-19.”

“We therefore hypothesize that diabetes and hypertension [high blood pressure] treatment with ACE2-stimulating drugs increases the risk of developing severe and fatal COVID-19,” the researchers concluded.

Although this news may exacerbate fears already present during the coronavirus pandemic, health experts encourage patients to stay on their medication despite the research letter.

“I strongly advise anyone on heart medications not to stop or change these without discussion with their doctor,” Dr Tim Chico, a professor of cardiovascular medicine at the University of Sheffield in the UK, told Daily Mail.

“If a patient stops their medication and worsens to the point of requiring admission to hospital at the same time as we are dealing with an increase in COVID-19 cases, that would pose the patient a considerable risk and put further strain on the healthcare services.”

Dr. Chico also notes that the research letter does not report any results from a clinical trial, so fear may not be necessary. Instead of reporting concrete results, the research letter raising questions about the possible risks associated with ACE inhibitors and ARBs such as valsartan blood pressure medication.

Contamination in Valsartan Blood Pressure Medication

ARBs have also been related to a massive recall after carcinogenic contamination was found in lots of valsartan, losartan, irbesartan and other “-sartan” drugs.

In 2018, the FDA learned that valsartan was contaminated with N-Nitrosodimethylamine (NDMA), an environmental contaminant and probable human carcinogen. Later, the recall was expanded to include other ARBs contaminated with additional nitrosamine impurities such as N-Nitrosodiethylamine (NDEA), a probable human carcinogen, and N-Nitroso-N-methyl-4-aminobutyric acid (NMBA), a potential human carcinogen.

According to the FDA, the presence of nitrosamine impurities in ARBs is “unexpected.” The agency has investigated the issue and determined that the carcinogenic contaminants may be generated when the drugs’ active pharmaceutical ingredient is manufactured. If materials, such as solvents, are reused, chemical and reaction conditions during the manufacturing process can reportedly lead to the development of NDMA and other nitrosamine impurities.

“Now that we know some of the root causes of the nitrosamine impurity problem, we’re using these findings to inform our evaluation of medicines other than ARBs,” the FDA said in an August 2019 update.

“In the meantime, we continue to work with ARB manufacturers to remove all affected drugs from the market, and we work with API manufactures to fix their processes so they do not distribute affected API to drug product manufacturers.”

Although countless lots of valsartan blood pressure medication are being recalled, not all lots are affected. Instead, a handful of lots from various manufacturers, repackaging companies, or combination drugs.

Consumers who suffered from complications after taking contaminated valsartan, they may be able to take legal action. Pharmaceutical companies have a duty to manufacturer and sell a safe product. If carcinogenic contamination was a result of negligence, consumers may have standing under consumer protection laws.