World Hypertension Day: High blood pressure and its Covid-19, CVD connection and how patients should take care

t has been more than two years since the Covid-19 pandemic has wreaked havoc worldwide leaving absolutely everyone affected in some way or the other. The World Health Organization (WHO) recently warned that the pandemic is “not over”, and had mentioned that the rise in the daily cases in more than 50 countries shows the “volatility of this virus”. Despite extensive research over the last two years, there is still so much left to be found out about the novel coronavirus. But various global observational studies have found that patients with pre-existing co-morbidities such as hypertension, diabetes mellitus, and cardiovascular diseases are more susceptible to COVID-19 infection and its complications.

This raises the question about the possible relationship between Covid-19 and hypertension and other cardiovascular diseases.

In one of the largest studies conducted between December 11, 2019, and January 29, 2020, in Wuhan, where Covid-19 originated, with data encompassing 1,099 COVID-19 patients, 165 patients (∼15%) had high blood pressure.

A separate study in China that took into account 138 laboratory-confirmed COVID-19 patients witnessed a similar high prevalence (31.2%) of hypertension. The researchers also found that 58.3% of hypertensive patients with COVID-19 infection were admitted to ICU compared to 21.6% of patients with normal blood pressure.

Dr. Sreekanth B Shetty, Senior Consultant & Head – Interventional Cardiology, Sakra World Hospital Bengaluru talking to the Financial Express informed that blood pressure in patients who are critically ill with covid, may be high or low depending on several variables. “It is observed that non-critically ill covid infected patient’s blood pressure can rise and the dosage of BP medicine might go up due to the infection. If a person with pre-existing high blood pressure was infected by Covid, they are more prone to developing Covid-related complications.

When asked if hypertension cases have spiked since the pandemic and if stress is a probable reason, he informed that there indeed was a spike in hypertension cases during the pandemic, as a direct effect of COVID where patients witnessed higher blood pressure. Moreover, some patients also developed new onset of blood pressure due to their treatment.  “Due to change in circumstances and work-from-home scenario, there was a reduction in Non-Exercised Physical Activity (NEPA). Along with this, there were various changes in diet and food habits as well, where people gained more weight and became prone to rise in blood pressure.”, Dr. Shetty said.

So, does the higher risk of hypertension patients suffering from severe Covid-19 come from certain drugs used to treat it like ACE inhibitors and angiotensin receptor blockers?

To this Dr. Shetty said, “With respect to certain drugs causing a rise in hypertension among people, there was initial hypothesis on the same, where people felt that these drugs caused a rise in severity of Covid, but the results proved that ACE inhibitors and ARB’s, provided better protection for patients with Covid.”

Hypertension is a medical condition in which the blood vessels have persistently raised pressure. But with lifestyle modification and medication, the condition can be checked. For patients with chronic conditions like hypertension or diabetes who were infected by the Covid-19 infections Dr. Shetty recommends

-Diligent check-up of blood pressure, sugar, cholesterol
– Regular check-ups with their doctors to make sure that their medical doses are optimized.

Moreover, people who are obese and have irregular diets are more prone to have hypertension and covid-related complications. Hence, “regular exercise is important and they need to cut down on carbohydrates as well.” he added.