Monitoring, Treating High Blood Pressure in the COVID-19 Era

High blood pressure, or hypertension, is very common acrossthe U.S., with an estimated one out of every two or three adults suffering fromthis major risk factor for heart attack or stroke — and many don’t realize it.

High blood pressure is called the “silent killer” because most of the time hypertension has no obvious symptoms to indicate that something is wrong. Hypertension is the primary risk factor for strokes.

Now, with the COVID-19 pandemic, early studies of hospitalizationsand deaths in the U.S. caused by the coronavirus indicate that high bloodpressure is a common underlying health condition among patients with seriousCOVID-19 complications. However, Ian Del Conde, M.D., acardiovascular specialist at Miami Cardiac & Vascular Institute, saysthat shouldn’t be a surprise because high blood pressure is so common in thegeneral population. 

COVID-19 and High Blood Pressure

“As millions of people around the world have becomeinfected with COVID-19, it is inevitable that many of these patients also havehigh blood pressure,” explains Dr. Del Conde. “However, it isimportant to remember that there are more patients with high blood pressure whodo not have COVID-19 and who still need to make sure that the blood pressuresremain well controlled.”

People who have been diagnosed with hypertension andcontinue taking their meds should not be overly anxious about COVID-19, hesaid, as long as they properly treat and monitor their blood pressure.  

“It is well known that uncontrolled blood pressuresincrease the risk of serious conditions including heart attacks andstrokes,” says Dr. Del Conde. “It is therefore very important thatpeople with high blood pressure, regardless of COVID-19, continue taking goodcare of their blood pressure with frequent blood pressure monitoring and takingtheir blood pressure medications as prescribed.”

Dr. Del Conde emphasized that the medical community’s understandingof how pre-existing health conditions interact with COVID-19 is rapidlyevolving. “While it is true that people with underlying cardiovasculardiseases are more common to die from COVID-19, high blood pressure alone hasnot emerged as one of the strongest predictors for poor outcomes in thesepatients,” he points out.

What Exactly is Blood Pressure?

Blood pressure is the pressure of blood pushing against thewalls of your arteries. Arteries carry blood from your heart to other parts ofyour body. The first number in a blood pressure reading, called systolic bloodpressure, measures the pressure in your arteries when your heart beats. Thesecond number, called diastolic blood pressure, measures the pressure in yourarteries when your heart rests between beats. A normal blood pressure level isless than 120/80 mmHg.

A significant number of U.S. adults have become candidatesfor blood pressure medication or other treatment since stricter guidelines wereimplemented in late 2017. The stricter standard, the first major change inblood pressure guidelines in 14 years, redefined a reading of high bloodpressure as 130/80, down from 140/90. An increasing number of adults under theage of 45 are now hypertensive.

 The new guidelines nolonger include the category of “prehypertension,” which previously kicked in atsystolic readings between 120 and 139 or a diastolic range between 80 and 89.

Meds That Control High Blood Pressure

Dr. Del Conde says there was much early speculation during theCOVID-19 pandemic over whether patients taking blood pressure medications – suchas “ACE inhibitors” or “ARBs” (medications that widen, or dilate, blood vessels) —were at increased risk of becoming infected with the coronavirus.

So far, there have been many large studies conducted inseveral countries and “all of the studies have reached the sameconclusion: that ACE inhibitors and ARBs do not increase the risk of becominginfected with COVID-19, and do not increase the risk of death in patients whohave become infected with COVID-19,” Dr. Del Conde says.

That’s even more reason for people with hypertension tocontinuing taking their meds as prescribed. 

“Many cardiology societies across the world have taken the same stance: Patients who are taking ACE inhibitors or ARBs for valid reasons should continue taking them because the risk of harm is greater if they stopped them,” stresses Dr. Del Conde.