The role of antihypertensives, especially Renin–Angiotensin–Aldosterone System inhibitors, is still debatable in COVID‐19‐related severity and outcome. Therefore, we search for a more global analysis of antihypertensive medication in relation to SAS‐CoV‐2 severity using prescription data worldwide. The association between the percentage use of different types of antihypertensive medications and mortality rates due to a SARS‐CoV‐2 infection during the first 3 weeks of the pandemic was analyzed using random effects linear regression models for 30 countries worldwide. Higher percentages of prescribed angiotensin receptor blockers (ARBs) (β, 95% confidence interval [CI]; −0.02 [−0.04 to −0.0012]; p = .042) and calcium channel blockers (CCBs) (β, 95% CI; −0.023 [−0.05 to −0.0028]; p = .0304) were associated with a lower first 3‐week SARS‐CoV‐2‐related death rate, whereas a higher percentage of prescribed angiotensin‐converting enzyme inhibitors (ACEis) (β, 95% CI; 0.03 [0.0061–0.05]; p = .0103) was associated with a higher first 3‐week death rate, even when adjusted for age and metformin use. There was no association between the amount of prescribed beta‐blockers (BBs) and diuretics (Diu) and the first 3‐week death rate. When analyzing the combination of drugs that is used by at least 50% of antihypertensive users, within the different countries, countries with the lowest first 3‐week death rates had at least an angiotensin receptor blocker as one of the most often prescribed antihypertensive medications (ARBs/CCBs: [β, 95% CI; −0.02 [−0.03 to −0.004]; p = .009], ARBs/BBs: [β, 95% CI; −0.03 [−0.05 to −0.006]; p = .01]). Finally, countries prescribing high‐potency ARBs had lower first 3‐week ARBs. In conclusion, ARBs and CCB seem to have a protective effect against death from SARS‐CoV‐2 infection.

中文翻译：

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抗高血压药物及其与 SARS-CoV-2 感染死亡率的关系

抗高血压药物，尤其是肾素-血管紧张素-醛固酮系统抑制剂在与 COVID-19 相关的严重程度和结果方面的作用仍然存在争议。因此，我们利用全球处方数据寻找与 SAS-CoV-2 严重程度相关的抗高血压药物的更全面的分析。使用随机效应线性回归模型对全球 30 个国家/地区的不同类型抗高血压药物的使用百分比与大流行前 3 周内 SARS-CoV-2 感染引起的死亡率之间的关联进行了分析。处方血管紧张素受体阻滞剂 (ARB)（β，95% 置信区间 [CI]；-0.02 [-0.04 至 -0.0012]；p  = .042）和钙通道阻滞剂 (CCB)（β，95% CI； -0.023 [-0.05 至 -0.0028]；p  = .0304）与较低的前 3 周 SARS-CoV-2 相关死亡率相关，而处方血管紧张素转换酶抑制剂 (ACEis) 的比例较高（β，95% CI；0.03 [0.0061–0.05]；p  = .0103) 与较高的前 3 周死亡率相关，即使根据年龄和二甲双胍使用情况进行调整。处方β受体阻滞剂 (BB) 和利尿剂 (Diu) 的用量与前 3 周死亡率之间没有关联。在分析不同国家中至少 50% 的抗高血压使用者使用的药物组合时，前 3 周死亡率最低的国家至少将血管紧张素受体阻滞剂作为最常开的抗高血压药物之一（ ARB/CCB：[ β，95% CI；−0.02 [−0.03 至 -0.004]；p  = .009]，ARB/BB：[ β，95% CI；−0.03 [−0.05 至 -0.006]；p  = .01]）。最后，开出高效 ARB 处方的国家前 3 周 ARB 用量较低。总之，ARB 和 CCB 似乎对 SARS-CoV-2 感染死亡具有保护作用。