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COVID-19 & Hypertension: What You Need To Know

According to recent reports by WHO, there are 4,034,567 COVID-19 infected persons around the world, with 276,690 deaths. Researchers and health experts around the globe are ardently focused on studying the novel coronavirus, where new findings and understanding help in the better management of the diseases, and also pave way for a possible effective vaccine, as soon as possible.

By focusing on the reported symptoms and risk factors, researchers are carrying out symptoms related studies, where factors such as obesity, smoking, diabetes, air pollution etc. have been explored. Recently, researchers have explored the link between COVID-19 and hypertension [1].

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What Is Hypertension Or High Blood Pressure?

Blood pressure is the force of the blood against the blood vessels. The normal blood pressure for an adult is 120/80 mmHg, and any deviation from this is considered unhealthy. A decrease in blood pressure is called hypotension, whereas an increase is called hypertension [2].

Basically, high blood pressure occurs when your blood pressure increases to unhealthy levels and is a common health issue [3]. Hypertension usually develops over the course of several years and may not show any symptoms. However, even in the absence of symptoms, the condition can cause damage to your blood vessels and organs, especially the brain, heart, eyes, and kidneys [4].

Hypertension treatment includes both medication and healthy lifestyle change, and if not treated, the condition could lead to health issues, including heart attack and stroke [5].


Coronavirus And Hypertension: Is There A Link?

With hundreds of papers being published on examining each and every aspect of the coronavirus disease, the recent existing condition to be explored is hypertension or high blood pressure [6].

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Various studies have pointed out that underlying health conditions such as hypertension can increase the risk of contracting SARS-CoV-2 and creating complications with the symptoms of COVID-19 [7].

According to one such study, about 28 per cent of the individuals who were admitted with COVID-19 had hypertension, where the researchers added, "hypertension is exceedingly frequent in the elderly, and older people appear to be at particular risk of being infected with SARS-CoV-2 virus and of experiencing severe forms and complications of COVID-19" [8].


Hypertension Or High Blood Pressure Medication May Increase The Risk Of COVID-19

The most common medications prescribed for individuals with high blood pressure are enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), which falls under the group of drugs called renin-angiotensin-aldosterone system (RAAS) antagonists [9]. Antagonist medications are substances that act against and block action.

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These medications, in turn, interrupt activity at a receptor called ACE2, which the coronavirus ‘uses' to gain entry into the lungs - thereby worsening the symptoms and the infection in the respiratory system [10].

The medications used in the treatment of hypertension have been shown to increase the number of ACE2 receptors, which may increase the risk of complications in COVID-19 patients with hypertension [11]. In addition to this, the medications can also increase the number of entry points for the virus.

"The medications could theoretically increase the binding of SARS-CoV-2 to the lung and its pathophysiological effects, leading to greater lung injury" [12].


While Some Researchers Suggest Hypertension Medication For COVID-19

Like the nature of any other study, the research on the relation between COVID-19 and hypertension also had conflicting views where some researchers have suggested ARBs as a potential treatment for COVID-19, while some proposed soluble ACE2 as a therapy [13].

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This idea was suggested with the point that increased levels of ACE2 may help in cleaning up the virus present in the patient's body due to its binding nature and thereby prevent the virus from reaching the lungs and other organs.

"The hypertension drugs could diminish the potential for the development of either acute respiratory distress syndrome, myocarditis, or acute kidney injury, which can occur in COVID-19 patients" [14].


On A Final Note…

In a concluding thought, it can be pointed out that people with hypertension should continue their medication as there is no solid proof which states that ACE inhibitor or ARB use is harmful or beneficial.

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Story first published: Saturday, May 9, 2020, 18:15 [IST]