5 May 2020

We refer to the Reuters report, “Blood-pressure drugs are in the crosshairs of Covid-19 research” (April 23).

Angiotensin converting enzyme (Ace) inhibitors and angiotensin receptor blockers (ARB) are classes of medication that are highly effective and are commonly used to treat high blood pressure and heart failure. These classes of medication are known to have a long-term protective effect on the heart and kidneys, especially in diabetic patients.

There have been reports that Ace inhibitors or ARBs may increase a patient's chances of being infected with Covid-19 or becoming more susceptible to a severe form of the infection.

Scientists proposed this hypothesis based on how the coronavirus that causes Covid-19 may be better at attacking a patient via the Ace2 receptor, which is found on the surface of different tissues including the lung and has multiple roles such as the modulation of blood pressure. This is because the numbers of these receptors are increased in patients receiving treatment for high blood pressure and heart issues, for instance.

We would like to point out that the current medical evidence suggests that these classes of medication have a neutral impact on or are even beneficial for patients with Covid-19 infections.

Experts from several international societies, as well as the Agency for Care Effectiveness under Singapore’s Health Ministry, encourage patients to continue their Ace inhibitor and ARB medication as prescribed by their doctors. Discontinuation of these important drugs without consulting your doctors may have serious health consequences.

The Singapore Cardiac Society and the Chapter of Cardiologists in the College of Physicians at the Academy of Medicine Singapore will continue to monitor this area closely.


Dr Ong Hean Yee is president of the Singapore Cardiac Society. Adjunct Associate Professor Yeo Khung Keong is chair of the Chapter of Cardiologists in the College of Physicians at the Academy of Medicine Singapore. Associate Professor David Lye is president of the College of Physicians at the Academy of Medicine Singapore. 

This letter can be viewed here and on TODAYonline.