COVID-19 and high blood pressure: Why hypertension patients can be severely affected by the disease

COVID-19 was first reported in Wuhan, Hubei Province, China on the 31 December 2019. Since then, much research has been done into establishing who is the most vulnerable to this new disease and how can the disease’s impact be reduced for these at-risk populations. COVID-19 patients who have other underlying conditions or comorbidities are one of the groups which are most vulnerable to having complications if they contract the infection. As per some reports, the most common comorbidities are hypertension (30 percent), diabetes (19 percent) and coronary heart disease (8 percent). About 99 percent of COVID-19 patients who died in Italy had either hypertension or other diseases like cancer, diabetes or other lung diseases. About 76 percent of these were patients who were suffering from high BP. Similarly in China, 25 percent to 50 percent of COVID-19 patients had either of these diseases. Therefore, patients suffering from high blood pressure are slightly more at risk of dying from coronavirus. The risk for them is 6 percent higher than that of a normal coronavirus patient. The frequency of COVID-19 patients being hypertensive is not completely surprising neither does it imply that there is a causal relationship between hypertension and COVID-19. Hypertension is more prevalent among older people; hence the elderly appear to be at a higher risk of being infected with SARS-CoV-2 virus. They also experience severe forms and complications of COVID-19. The link between COVID-19 and hypertension Immunity has been talked about a lot during the pandemic and with good reason. One needs to have a well-functioning immune system to be able to fight off COVID-19 without too many adverse effects. However, prolonged exposure to health problems and old age reduces the ability of the immune system to fight. Therefore, people with a weaker immune system are at a higher risk of complications and death due to coronavirus. What needs to be noted is that nearly two-thirds of the world population above the age of 60 have hypertension. Another possible reason why people with hypertension are at a higher risk is the drugs they use to treat the disease and not the disease itself. Hypertension and other cardiovascular diseases which are often found in COVID-19 patients are treated with angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs). Both these drugs increase the level of ACE2 in the body and COVID-19 viruses attach themselves to this enzyme to infect the cells. There is, however, no evidence that hypertension is connected to the outcomes of coronavirus, or that ACE inhibitor or ARB use is harmful or beneficial during the pandemic. Besides, it is best that you don’t discontinue the use of these agents unless your doctor tells you to. According to the American Heart Association and American College of Cardiology, discontinuing the medicines could cause a stroke or a heart attack for a patient, and that, in turn, will take the patient to the hospital, where there will be a higher risk of exposure to the virus. How COVID-19 affects people with hypertension  The virus has the ability to damage the cardiovascular system among other things. Hence, patients of hypertension and heart diseases are at a higher risk of COVID-19 complications. Hypertension, over time, damages the arteries, leading to a reduced amount of blood flowing to the heart. The heart is then forced to work harder to pump enough blood. When this occurs for a long time, it can weaken the heart and at some point, the heart may not be able to pump the required amount of oxygen-rich blood. During such conditions, COVID-19 could prove to be very dangerous because it may lead to inflammation of the heart muscles. If a patient is also suffering from plaque build-up in their arteries, the virus has the potential to break the plaque and cause a heart attack. What precautions can be taken Everyone needs to be cautious during the pandemic. However, patients of hypertension or other diseases like lung disease, heart diseases, cancer or diabetes need to take more precautions than others. Here are ways for a person to protect themselves from the COVID-19 virus:

• Take all medications for high BP and other diseases on time to prevent a hospital visit and keep basic medicines at home to treat fever or other mild illnesses.
• For as long as possible, avoid contact with people and stay at home.
• Always wear a mask when going out.
• Wash your hands for 20 seconds with soap and water or use an alcohol-based sanitizer.
• Remember to clean and disinfect the commonly touched areas such as doorknobs.
• Talk to your doctor about taking a pneumococcal vaccine to prevent pneumonia.

This article is written by Dr Kamal Gupta, Principal Consultant-Cardiology, Fortis Escorts Hospital, Faridabad.  For more information, read our article on High Blood Pressure. Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.