We are currently in the midst of a COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). At the time of writing, more than 15 million people have been diagnosed to have the infection, with more than 6,00,000 deaths worldwide. During this time, while the world’s focus is on the COVID-19, there is a danger that other illnesses might be overlooked. Indeed, hospitals have reported a decrease in the number of patients attending emergency departments with heart attacks and strokes. It is likely that patients are concerned about contracting the virus while attending the hospital and are staying away. In addition to the acute conditions, management of stable chronic illnesses such as hypertension and diabetes may also be affected.
The current circumstances have created lot of anxiety, fear and doubts in the minds of patients suffering from hypertension. We have tried to address some of the frequently asked questions related to the management of hypertension during these testing times.
1.I am suffering from systemic hypertension. Is that a matter of concern?
Emerging data from various countries most affected by COVID-19 reveal that hypertension is strongly associated with poor clinical outcomes and was the most common co-morbidity in the patients (30-50%) requiring intensive care unit (ICU) admission or mechanical ventilation or who succumb to death. The reason for this apparent association remains unclear. The severity and mortality of the infection is higher in the elderly age group. As hypertension is strongly age related, the data could simply be confounded by age. However, an alternative explanation is end-organ damage in hypertensive patients. Hypertension results in a number of pathophysiological changes in the heart, kidneys, brain and blood vessels. This may make the hypertensive patients particularly susceptible to SARS-CoV-2.
The recommendation is to follow local government guidelines to avoid getting infected with Corona virus which includes measures like social distancing, hand sanitisation, wearing appropriate masks and protective gears etc. Optimal control of blood pressure may reduce the risk of adverse outcomes with COVID-19.
2. I take blood pressure-lowering medication. What does COVID-19 mean for me?
Keeping your blood pressure under control through medicines (if you’re taking any) and lifestyle measures is a top priority during the COVID-19 pandemic. It’s important to continue taking your regular blood pressure-lowering medicines as prescribed by your doctor. The availability of medications can be difficult during lockdown period, hence it is important to maintain extra stocks of the regular medications.
3.Do blood pressure-lowering medicines make COVID-19 more severe?
No, the opposite is true. Having uncontrolled, high blood pressure is a risk factor that increases the likelihood of serious illness if you do become infected with SARS-CoV-2 (the virus that causes COVID-19). Studies have found that cardiovascular disease is one of the most common underlying conditions in people with COVID-19 who had poor outcomes from the infection. This is why leading Australian and international heart-health experts recommend you take your medicines, including those used to manage your blood pressure, as prescribed by your doctor during the coronavirus pandemic.
4. Why have I seen news articles saying that some blood pressure-lowering medicines might be harmful if I am infected with SARS-CoV-2?
Currently, researchers are trying to find out why some people who are infected with SARS-CoV-2 are sicker than others and progress to more serious COVID-19 disease. To understand why more people with cardiovascular disease, including high blood pressure, experience serious illness, researchers began to investigate whether there were any links between SARS-CoV-2 and their medications.
Based on some early research into coronavirus, it was suggested that blood pressure-lowering medicines called angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) might make it easier for a person to be infected with COVID-19 or increase the likelihood of them becoming seriously ill if they do get sick with the virus. However, leading Australian and international experts in heart health have been looking at the scientific information available.
They all agree that there is no direct clinical evidence to suggest that taking these medicines is harmful during the COVID-19 pandemic. In fact, available evidence shows that stopping your blood pressure-lowering medicines is more likely to lead to health problems.
5. How to monitor blood pressure during this period?
Routine hospital visits for non-urgent medical problems should be avoided during this period. However, monitoring the blood pressure values is important to confirm that blood pressure is in optimal range. Home blood pressure monitoring with digital BP monitoring instruments is very useful in these circumstances. Taking multiple BP readings at different times during a day and maintaining a diary is essential. In case if the readings are not satisfactory, one can consult the doctor through video consultation or clinic visit.
6. What are other measures to follow apart from medications?
In addition to regular medications, it is important to continue eating a healthy diet with plenty of fresh vegetables and fruits, limiting alcohol intake, and stopping smoking if possible. Regular exercise, meditation and yoga may not only help in controlling blood pressure but also reduces anxiety during this stressful period. Drinking adequate amount of water improves hydration. Excess dietary salt intake should be avoided.
We have tried to solve the common queries presented to us by patients. In case of any doubts, please feel free to contact.