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

High blood pressure, or hypertension, is very common across the U.S., with an estimated one out of every two or three adults suffering from this 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 hospitalizations and deaths in the U.S. caused by the coronavirus indicate that high blood pressure is a common underlying health condition among patients with serious COVID-19 complications. However, Ian Del Conde, M.D., [1] a cardiovascular specialist at Miami Cardiac & Vascular Institute [2], says that shouldn’t be a surprise because high blood pressure is so common in the general population. 

COVID-19 and High Blood Pressure

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

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

“It is well known that uncontrolled blood pressures increase the risk of serious conditions including heart attacks and strokes,” says Dr. Del Conde. “It is therefore very important that people with high blood pressure, regardless of COVID-19, continue taking good care of their blood pressure with frequent blood pressure monitoring and taking their blood pressure medications as prescribed.”

Dr. Del Conde emphasized that the medical community’s understanding of how pre-existing health conditions interact with COVID-19 is rapidly evolving. “While it is true that people with underlying cardiovascular diseases are more common to die from COVID-19, high blood pressure alone has not emerged as one of the strongest predictors for poor outcomes in these patients,” he points out.

What Exactly is Blood Pressure?

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

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

 The new guidelines no longer include the category of “prehypertension,” which previously kicked in at systolic 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 the COVID-19 pandemic over whether patients taking blood pressure medications – such as “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 in several countries and “all of the studies have reached the same conclusion: that ACE inhibitors and ARBs do not increase the risk of becoming infected with COVID-19, and do not increase the risk of death in patients who have become infected with COVID-19,” Dr. Del Conde says.

That’s even more reason for people with hypertension to continuing 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.