One of the most frequent conditions in people with COVID-19 is high blood pressure, or hypertension. It is also the most commonly seen disease in patients with serious complications from COVID-19, such as acute respiratory distress. However, this relationship between COVID-19 and arterial hypertension is not surprising, nor does it necessarily mean there is a causal relationship between them, or that it is associated with more serious illness. In fact, it is a very logical relationship, considering that hypertension is extremely common in older people and that this group is at highest risk of catching COVID, and of experiencing serious cases with more complications.
Until now, it was still too early to be able to draw conclusions, but a recently published study with data from 150 Spanish hospitals shows that hypertension is associated with a greater risk of COVID-19 mortality, regardless of the age and sex of the patient, with this risk being reduced in those receiving treatment. The study analyses more than 12,000 patients, and it was observed that of those who died, 50% had high blood pressure. Furthermore, to confirm these conclusions, the results in patients with hypertension were compared to those of patients with normal blood pressure.
What’s more, there is an aspect related to high blood pressure treatment that should also be kept in mind. The receptor that the coronavirus uses to enter the cells is the same one used by certain blood pressure drugs. This is the case with angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB). For this reason, questions have been raised about whether these treatments may be beneficial or harmful. There is a hypothesis that taking these drugs may increase the chance of catching COVID-19, or of having a worse prognosis. However, the data available so far indicates that these treatments may even reduce the potential risk of developing acute respiratory distress syndrome, myocarditis or acute kidney damage, common complications in patients with COVID-19. Even so, more studies are needed.
In conclusion, today it has already been confirmed that high blood pressure worsens the prognosis of COVID-19, although it is still not known whether some treatments for hypertension are harmful or beneficial to the development of the disease. What is more, based on the current evidence, antihypertensive therapies must be maintained to guarantee proper control of arterial pressure.
Author: Dr Miguel Camafort Babkowski, doctor at the Internal Medicine Department at Hospital Clínic de Barcelona