Essential hypertension is the most common cardiovascular (CV) risk factor, being primarily involved in the pathogenesis of CV disease and mortality worldwide. Given the high prevalence and growing incidence of this clinical condition in the general population in both high and low-income countries,
antihypertensive drug therapies are frequently prescribed in different
hypertension-related CV diseases and comorbidities. Among these conditions, evidence are available demonstrating the clinical benefits of lowering blood pressure (BP) levels, particularly in those hypertensive patients at high or very high CV risk profile. Preliminary studies, performed during the Sars-COVID-19 epidemic, raised some concerns on the potential implication of
hypertension and
antihypertensive medications in the susceptibility of having severe
pneumonia, particularly with regard to the use of drugs inhibiting the renin-angiotensin system (RAS), including
angiotensin converting enzyme (
ACE) inhibitors and
angiotensin receptor blockers (ARBs). These hypotheses were not confirmed by subsequent studies, which independently and systematically demonstrated no clinical harm of these drugs also in patients with Sars-COVID-19
infection. The aim of this narrative review is to critically discuss the available evidence supporting the use of
antihypertensive therapies based RAS blocking agents in hypertensive patients with different CV risk profile and with additional clinical conditions or comorbidities, including Sars-COVID-19
infection, with a particular focus on single-pill combination
therapies based on
olmesartan medoxomil.