What you need to know about the link between COVID and Hypertension

Share on facebook
Share on twitter
Share on linkedin

As of March 2021, WHO (World Health Organization) reported a total of 132K+ Covid cases. The worldwide pandemic which is caused by the SARS-CoV-2 virus became the high point as we saw it spreading to every nook and corner of the world in a very short time. With on and off lockdowns being announced in every country, let’s explore the link between Covid-19 and high-risk medical conditions such as hypertension.

Who is in the high-risk group

First and foremost, below are some of the important facts related to high-risk groups:

• Risk for severity by COVID-19 increases with age.

• High-risk or chronic medical conditions can also increase the risk for illness.

• Needless to say, people visiting those with high-risk medical conditions must take precautions to protect themselves from contracting the virus.

While you may be aware that Covid-19 symptoms differ from person to person, it’s important to know that it affects certain people to a dangerous extent of requiring immediate hospitalization. The risk of developing extreme symptoms increases in people who are older and/or those who have other serious health problems such as:

1. Heart conditions (hypertension, heart failure, coronary artery disease)

2. Cancer and certain blood disorders

3. Chronic kidney disease or liver disease

4. Chronic lung diseases (COPD, asthma, pulmonary hypertension, etc.)

5. Dementia & other neurological conditions

6. Diabetes

7. Weakened immune system

8. Obesity

9. Respiratory illness such as influenza

10. HIV infection

11. Pregnancy

12. Stroke

13. Down syndrome

In addition:

• More than 80% of deaths occur in people over age 65, and more than 95% of deaths occur in people older than 45 — both due to COVID-19.

• While children have been less affected by COVID-19 compared with adults, certain underlying medical conditions in children are associated with increased risk. Evidence suggests that children with medical conditions such as genetic, neurologic, metabolic conditions can be at increased risk for severe illness from COVID-19.

If you have any of the aforementioned medical conditions or are of age older than 45 years, we highly recommend booking an appointment with your healthcare provider about steps you could take to manage your health.

Why is hypertension a risk factor?

In this article, we’re interested to explore hypertension and the associated risk in Covid-19 symptoms. Especially since the majority of the population aged over 60 years have hypertension so it’s important to understand their increased risks with respect to the latest virus. Hypertension has been widely reported to increase the severity of patients with the COVID-19 virus.

As per the Polish Archives of Internal Medicine, it was found that hypertension is associated with ~2.5-fold increased risk of both increased severity and mortality. And this has been mainly observed in those over the age of 60.

As per the Journal of Human Hypertension, The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team published a case from China where they found an overall case fatality rate of 2.3% (1023 of 44,672 confirmed cases), which increased to 6.0% for people with hypertension. Both COVID-19 case fatality rates and hypertension prevalence increase with age, reaching 8.0% and over 50% respectively for the 70–79 year age group.

Link between ACE2 enzyme and COVID-19 Patients

As per NIH (National Institute of Health), a study included 1099 patients with confirmed COVID-19, of whom 173 had severe disease with comorbidities of hypertension (23·7%). In another study, 3 of 140 patients who were admitted to hospital with COVID-19, 30% had hypertension.

Please note that the most frequent medical conditions reported in the above studies of patients with COVID-19 are often treated with angiotensin-converting enzyme (ACE) inhibitors. They are also known as RAAS (Renin-Angiotensin-Aldosterone System) inhibitors.

Coronavirus which is SARS-CoV-2 is known to bind to their target cells through an enzyme called angiotensin-converting enzyme 2 (ACE2) which is secreted by the lungs, intestine, kidneys, and blood vessels.

Since ACE inhibitors (or RAAS inhibitors) increase the level of ACE2 enzymes, there is a higher prevalence of ACE2 enzymes in hypertension patients because they are generally treated with ACE inhibitors and ARBs, to alleviate their hypertension medical condition.

Subsequently, this increased expression of the ACE2 enzyme would facilitate infection with COVID-19 giving an easier leeway for the virus to enter the body. Therefore, it has been concluded that hypertension treatment with ACE2-stimulating drugs increases the risk of developing severe and fatal COVID-19. Since the Coronavirus latches onto the ACE2 enzyme in these high-risk patients.

This causes a major conflict since ACE2 reduces inflammation in patients with inflammatory lung diseases, cancer, diabetes, and hypertension. It is suggested that patients with hypertension or other chronic conditions, who are treated with ACE2-increasing drugs, are at higher risk for severe COVID-19 infection and, therefore, should be monitored for better management of their overall health risks.

Latest critical studies for hypertensive patients

However, a recent study of 6,272 patients from Lombardy, Italy demonstrated that neither ARBs or ACE-Is had a significant association with COVID-19 cases or fatal outcomes. The majority of the peer-reviewed studies published till now have not found higher rates of infection or increased mortality among patients treated with RAAS inhibitors. Organizations such as the ACC, AHA, and Heart Failure Society of America released a joint statement advising against discontinuation of RAAS inhibitors for such patients. This statement is also supported by major international scientific societies including the International Society of Hypertension, European Society of Hypertension, European Society of Cardiology, Canadian Cardiovascular Society, and Canadian Heart Failure Society.

Studies are being conducted to explore more into the impact of hypertension on Covid-19 infection. Until more information is available, it is important to treat hypertensive patients to manage their conditions. This information is last updated by the American College of Cardiology in July 2020.

While another study of 12,594 electronic health records from New York, found no association between any anti-hypertensive medication and Covid-19.

What you should do

• Ensure you have or continue to take medication for hypertension

• Seek a medical professional’s help regarding your medication and what other precautions might be needed

• Load up on over-the-counter medicines to treat fever and other symptoms if you get sick

• Stay at home, avoid crowds and limit contact with other people as much as you can.

• Do wear a face mask if you have to be in a public placeWash your hands often with soap and warm water and always carry a hand sanitizer

• Clean and disinfect all frequently touched surfaces such as a doorknob, handphone, etc.

It’s imperative to support your hypertension condition in continuing to maintain good blood pressure control via medications as prescribed, and by striving to follow and maintain healthy lifestyle choices, including regular exercise.

Ongoing and latest research developments will also provide further data that will be a crutch for you to rely upon and eventually make an informed decision regarding your health, with the help of medical professionals of course. Peer-reviewed and credible research are vital for an understanding of the risk of hypertension with COVID-19, and to determine the best and safest ways to treat those with severe medical conditions.

Until then, continue to stay cautious and stay safe!

Albot Health

Albot Health

Leave a Replay

Good health starts with the right information

Get authentic health news delivered straight to your inbox once in a week. We hate spam too! Sign up now.