COVID-19 and High Blood Pressure: Exploring Their Link
In a recent study published in the American Heart Association's Circulation journal, it was revealed that blood pressure levels among adults in the United States remained stable between 2019 and January to March of 2020. However, from April to December of 2020, blood pressure numbers notably increased as compared to the same period in the previous year [1].
The COVID-19 pandemic has brought about a shift in the strategies for managing blood pressure (BP). The recommended approach focuses on maintaining optimal BP control and addressing hypertension in patients with or at risk of COVID-19 complications.
Recent guidelines and trials support aiming for a systolic blood pressure (SBP) goal of less than 130/80 mm Hg for most adults. Evidence suggests additional cardiovascular risk reduction when SBP is reduced even further to below 120 mm Hg in high-risk individuals, such as those with prior cardiovascular disease or diabetes [1]. Achieving these targets typically requires a combination of medications, including thiazide diuretics, ACE inhibitors, ARBs, and calcium channel blockers, often administered as combination pills to reduce pill burden and improve adherence [1].
For COVID-19 patients with pre-existing hypertension, there is currently no unified global guideline. However, comprehensive management includes routine symptomatic and supportive care alongside timely and effective antiviral therapy. The antiviral agents Paxlovid (nirmatrelvir plus ritonavir) and azvudine have shown benefits in reducing viral load and improving outcomes in COVID-19 patients with hypertension, suggesting the importance of early antiviral treatment in this group [2][3].
Antiviral therapies should ideally be started as soon as possible after diagnosis, preferably within 5 to 7 days of symptom onset, to reduce disease progression and complications [3]. Continuous monitoring and individualized treatment adjustments remain crucial to keeping BP controlled [4].
The study, conducted by Cleveland Clinic and Quest Diagnostics, looked at the blood pressure of participants in various employee wellness programs across the country from 2018 to 2020. Of the 464,585 participants, about 54% were women, and the average age was 46. Changes in systolic blood pressure ranged from 1.10 to 2.50 millimeters of mercury (mmHg), while changes in diastolic blood pressure ranged from 0.14 to 0.53 mmHg [1].
The Centers for Disease Control and Prevention (CDC) states that high blood pressure could make a person more likely to get severely ill if they contract COVID-19. High blood pressure, if left uncontrolled, increases the risk for cardiovascular issues and can lead to an increased risk for strokes, heart attacks, kidney disease, and other health threats [1].
Dr. Laffin, the lead author for the study, suggests that the pandemic disrupted health and wellness routines, including medication use, as a possible factor for the increases in blood pressure. He advises that it's important to get back to regular medication use and regular doctor's visits for blood pressure management. Lifestyle changes, such as maintaining ideal weight, exercising, watching dietary sodium, getting sufficient sleep, and moderating alcohol consumption, can also help manage high blood pressure [1].
Dr. Laffin emphasizes the importance of checking with healthcare providers to see if blood pressure medications should be adjusted due to changes in medical conditions and lifestyles. He suggests that older people saw changes in systolic numbers, while some younger participants experienced changes in their diastolic numbers [1].
In conclusion, managing blood pressure during and after the COVID-19 pandemic involves maintaining recommended BP targets with appropriate pharmacotherapy, ensuring early antiviral treatment for COVID-19 in hypertensive patients, and consistent follow-up to adjust therapies as needed. This integrated approach helps reduce cardiovascular risks exacerbated by both hypertension and COVID-19 infection [1][2][3][4].
- The recent study on American Heart Association's Circulation journal suggests that lifestyle changes, including maintaining ideal weight, exercising, watching dietary sodium, getting sufficient sleep, and moderating alcohol consumption, can aid in managing high blood pressure.
- The Centers for Disease Control and Prevention (CDC) indicates that high blood pressure could escalate the likelihood of severe illness for individuals contracting COVID-19, increasing the risk for cardiovascular issues, strokes, heart attacks, kidney disease, and other health threats.
- The study conducted by Cleveland Clinic and Quest Diagnostics revealed that inadequate sleep may be a contributing factor to the increases in blood pressure levels among adults in the United States, from April to December of 2020.
- For high-risk individuals, such as those with prior cardiovascular disease or diabetes, evidence suggests that additional cardiovascular risk reduction can be achieved by reducing systolic blood pressure below 120 mm Hg.
- The latest nutrition research is crucial for managing and preventing chronic diseases, especially those related to cardiovascular health, mental health, and various medical-conditions.
- As demonstrated in the study, mental health plays an essential role in fitness-and-exercise routines, sleep patterns, and overall nutrition, thereby impacting cardiovascular health and chronic diseases management.
