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COVID-19 and Hypertension

March 10, 2020
COVID-19 and Hypertension

While it seems that the outbreak is affecting nearly everyone in at least some way, it may be even more important for people with hypertension to stay informed. Infections with COVID-19 may be more severe in those with hypertension, and may also affect the action of antihypertensive medications.

Coronavirus Risks with Hypertension


Current data make it clear that people with underlying health conditions are at higher risk for developing more serious cases of COVID-19, including hospitalizations, the need for ventilation, or death. Overall, an estimate based on a study of 1,590 COVID-19 patients in China found that serious cases were 1.79 more likely for patients with one underlying health condition, such as hypertension, and 2.59 times more likely with 2 underlying health conditions. [4].

Calculate Your Risk of Diabetes: Your Blood Pressure

Systolic (Top Number) 80
low Risk

The World Health Organization (WHO) says people with hypertension are among the highest-risk groups for more serious cases of, and death from, COVID-19 [5]. The death rate 8.4% among confirmed cases and 6.0% among all cases. In comparison, the death rate among those with no-preexisting conditions was 0.9%. In addition, ICU patients in one study were more than twice as likely to have hypertension (58.3% versus 21.6%). [6]. 

*as of March 2020*
Death Rate
With Hypertension – confirmed cases
8.4%
All cases
6.0%
No prexeisting conditions
0.9%

In addition, the increased risk of serious cases with at least two underlying conditions may be relevant, as more than half of individuals with hypertension have obesity, and nearly half have impaired fasting glucose [7]. Prediabetes and diabetes not only raise risk for infections becoming more serious, but also for getting infected in the first place.

Why might individuals with hypertension get more serious cases of COVID-19? It is intuitive (more risk with more health conditions), but there seems to be a special link between COVID-19 and hypertension. The connection is related to angiotensin-converting enzyme 2 (ACE2) [8].

This enzyme acts on ACE2 receptors to increase blood pressure. The class of antihypertensives known as ACE inhibitors block this action to lower blood pressure. It appears, though, that COVID-19 and similar viruses bind ACE2. This has two main implications.

Implications of Hypertension and COVID-19

  1. Patients with hypertension and cardiovascular disease have higher levels of ACE2.
  2. Patients on ACE inhibitors and angiotensin-receptor blockers and their doctors may need to reevaluate their use of these medications if infected by COVID-19.

Standard Prevention Practices


The same things that can help prevent the spread of coronavirus in the general population can help lower your risk of getting sick. These are standard precautions for avoiding any contagious respiratory infection and are recommended by the CDC [9]. 

  • Wash your hands frequently, including after using the bathroom, being in a public place, or coughing or sneezing, and before eating.
  • Greet people with elbow bumps or bows instead of handshakes or hugs.
  • Use a tissue or your sleeve to touch high-traffic surfaces in public areas, such as door knobs, elevator buttons, and stair banisters.
  • Avoid touching your face, since germs can enter through the eyes, nose, and mouth.
  • Clean your home and phone thoroughly with disinfectants.

The CDC also suggests avoiding crowds and indoor gatherings when you can. Some strategies can include:

  • Watching sports events on TV instead of in person.
  • Streaming religious services online instead of in your regular place of worship.
  • Asking others to bring daily necessities, such as groceries and household items.
  • Use video chats to keep in touch instead of going to large gatherings.

Getting Prepared 


Having a plan for what might happen if you get sick can give you peace of mind now and help you get better faster in the case that you do get infected with COVID-19. Contacting your primary care doctor now can give you information about whom to call or where to go should you feel sick. 

It is important to have a list of phone numbers on hand so you can contact family members or friends quickly. You may also need to have a plan for having a caregiver. Having certain supplies on hand now can ensure that you do not run out should you get sick. These include food, household items, antihypertensives and any other medications you are on, and enough batteries for household items as well as, if needed, your home blood pressure monitoring system.

Boosting Your Immune System


Making healthier lifestyle choices can not only give you satisfaction that you are doing something to fight COVID-19, but can really boost your immune system and lower your risk for getting infected. Lark already encourages these choices and can guide you in making them. As another bonus, these can also help control blood pressure.

  • Getting plenty of vitamin C and other antioxidants from fresh fruits and vegetables.
  • Getting adequate sleep, which is 8 hours for most adults.
  • Being physically active, and striving for at least 150 minutes per week.
  • Managing stress.
  • Avoiding excessive alcohol.

Lark can help with these changes and guide you in making small steps to establish habits that last for the long-term.

If you have diabetes or prediabetes along with high blood pressure, it is especially important to control blood sugar, since hyperglycemia (high blood sugar) can interfere with regular immune function. Lark can help with additional steps to manage blood sugar, such as the following.

  • Monitoring blood sugar as often as your doctor suggests.
  • Checking your blood sugar trends and linking them to actions such as healthy eating or extra activity with Lark.
  • Losing excess weight. 
  • Choosing lower-sugar foods and beverages, and having more vegetables, whole grains, and lean proteins.
  • Adding bits of physical activity to your day to keep insulin sensitivity higher.
  • Taking medications as prescribed.

What If You Get Sick?


Common symptoms of coronavirus include coughing, fever, and shortness of breath. The intuitive thing to do may be to go to the doctor or emergency room when you get sick, but that may not be the first step to take. Instead, calling your doctor is safer if you have mild symptoms and suspect that you have coronavirus because going to a clinic or other facility:

  • This can expose you to sicker people who can share their germs.
  • It could spread coronavirus to others if you have it.
  • May divert needed resources away from more serious conditions.

Other steps to take are to avoid contact with others however possible, such as driving yourself rather than taking public transportation and sneezing into an elbow.

When to Go to the Doctor


There are some cases when you may need medical attention urgently. These can include excessively high blood pressure, or a hypertensive crisis. In addition, while over 80 percent of cases of COVID-19 have been mild, the infection can become serious. 

According to the CDC, these are the signs that have been linked to serious COVID-19 infections and require medical attention:

Calculate Your Risk of Diabetes: Your Blood Pressure

Systolic (Top Number) 80
low Risk
  • Trouble breathing or bluish face indicating inadequate oxygen levels
  • Chest pain or pressure
  • Confusion

As the COVID-19 outbreak continues to develop, the best things you can do are to keep yourself informed and to prepare. Preparing includes boosting your immune system, avoiding germs as much as you can, and planning ahead in case you do get sick. Lark can help you with your healthy habits without coming into contact with any germs, and may be your best 24/7 health partner right now!

Written by Natalie Stein on March 10, 2020
Exercise, Fitness & Nutrition Expert | Lark Health
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