Is Your High Blood Pressure Medication Putting You At Risk For COVID-19?

Since the beginning of the COVID-19 pandemic, fear-mongering and claims about miracle cures have brought lots of misinformation to the internet. Some ideas were quickly squashed, like the myth that ingesting bleach could protect against COVID-19. Other ideas are worth taking a deeper dive into, like the possible relationship between high blood pressure medication and COVID-19.

Where did this start?

In 2020, healthcare professionals noticed that those admitted to hospitals with COVID-19 tended to have chronic diseases. Most notable of all was hypertension, also known as high blood pressure. Blood pressure is a measurement of how forcefully your blood pushes against the walls of your arteries while it moves from your heart to other parts of your body. High blood pressure can damage your heart and arteries over time. But is it connected to COVID-19? In early studies, those with high blood pressure appeared to contract COVID-19 more easily and experience more severe symptoms.¹ In fact, in some studies, over thirty percent of people who died of COVID also had hypertension.² Soon after, the internet was taken over with its next COVID-19 claim: that high blood pressure medications increase the risk of COVID-19.

What does the evidence say?

• High blood pressure medications are related to coronavirus infection, but it is safest to continue their use. Some high blood pressure medications increase the enzyme that coronaviruses use to bind to their target cells.³ Many assume that this is why people with hypertension have worse outcomes from COVID-19 than those without hypertension. Although studies are still looking into this connection, the current evidence confirms that these medications are safe to take even during exposure to COVID-19.¹ Researchers speculate that some high blood pressure medications (ACE inhibitors and ARBs) could put people at greater risk than others (calcium channel blockers), but this hasn't been confirmed in clinical trials.³ Concerns about your blood pressure medication should be discussed with your physician, who will consider your individual hypertension and other COVID risk factors you may have.
• Controlling blood pressure is critical for COVID-19 outcomes. More recent studies find that uncontrolled systolic blood pressure is connected to more severe outcomes of COVID-19.¹ Systolic blood pressure is the first, or top number of a blood pressure measurement. It, measures the pressure while the heart beats. Uncontrolled systolic blood pressure can occur when people go off blood pressure medications. It is critical to stay on your blood pressure medication unless directed by your physician.
• Age might explain the connection between COVID-19 and high blood pressure. COVID risk and outcomes can be affected by many different factors. The most significant seems to be age, because of how the infection pathway changes with age.⁴ As people age, they are also more likely to have high blood pressure. This may explain the connection between high blood pressure and COVID-19. If you are concerned about how your age puts you at risk for COVID-19 or high blood pressure, discuss your options with your physician and consider lifestyle changes that could support a healthy blood pressure.
• We continue to learn more about COVID-19 and high blood pressure. Future studies are looking into whether high blood pressure is connected to "post-COVID syndrome" and "long COVID-19."⁴ Remember that researchers and healthcare providers are always learning more about these issues. Healthcare providers will continue to care for patients with the latest evidence in mind.

I have high blood pressure. What can I do?

Nearly a third of the people in our state of New Hampshire have been told by a healthcare provider that they have high blood pressure.⁵ If you have high blood pressure, consider the tips below:

1. Stay on your high blood pressure medication as prescribed by your doctor.
2. Eat a diet lower in salt. By choosing fewer processed foods and flavoring your meals with herbs and spices, you can lower the sodium you eat at each meal.
3. Get regular physical activity. By moving your body each day in an enjoyable and comfortable way, you support a healthy blood pressure.
4. Prioritize 7-9 hours of sleep. Develop a consistent sleep routine by going to bed and waking up at the same time each night.
5. Limit alcohol intake. Drinking no more than 1-2 alcoholic drinks a day can support overall health. Consider replacing alcoholic drinks with water or herbal tea.
6. Do not smoke. Smoking and vaping can cause irreversible lung damage and play a role in high blood pressure. Discuss options with your physician about quitting smoking.

The most effective way to lower your risk for COVID-19 is through vaccination and distancing yourself from those diagnosed with or exposed to COVID. If you have high blood pressure, you should not stop taking your medications. Instead, discuss options with your healthcare provider if you are concerned about COVID risk factors like age. Continue to take prescribed medications and make lifestyle choices that support healthy blood pressure, such as a low-sodium diet, regular exercise and consistent sleep.

References

1. Gallo G, Calvez V, Savoia C. Hypertension and COVID-19: Current Evidence and Perspectives. High Blood Press Cardiovasc Prev. 2022;29(2):115-123. doi:10.1007/s40292-022-00506-9
2. Tadic M, Cuspidi C, Grassi G, Mancia G. COVID‐19 and arterial hypertension: Hypothesis or evidence? J Clin Hypertens. 2020;22(7):1120-1126. doi:10.1111/jch.13925
3. Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? Lancet Respir Med. 2020;8(4):e21. doi:10.1016/S2213-2600(20)30116-8
4. Abdalla M, El‐Arabey AA, Gai Z. Hypertension is still a moving target in the context of COVID‐19 and post‐acute COVID‐19 syndrome. J Med Virol. Published online September 22, 2022:10.1002/jmv.28128. doi:10.1002/jmv.28128
5. Centers for Disease Control and Prevention. Behavioral Risk Factor Surveilance System Survey Data. Table of Hypertension Awareness. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2022. Accessed March 7, 2023. https://chronicdata.cdc.gov/Behavioral-Risk-Factors/BRFSS-Table-of-Hype…
6. Ostchega Y, Cheryl D. Fryar, Tatiana Nwankwo, Duong T. Nguyen. Hypertension Prevalence Among Adults Aged 18 and Over: United States, 2017–2018. 2020;(364).