Coronavirus and High Blood Pressure: What’s the Link?

If you have high blood pressure, it's a good idea to take extra care to protect yourself during the coronavirus (COVID-19) outbreak. There is a possibility that having high blood pressure might put you at greater risk for severe illness and death with COVID-19.

High Blood Pressure Risks

Analysis of early data from both China and the U.S. shows that high blood pressure is the most commonly shared preexisting condition among those hospitalized, affecting between 30% to 50% of the patients. Other health conditions included cancer, diabetes, or lung disease. In Italy, a report said that more than 99% of people who had died from the virus had one of these conditions -- and 76% of them had high blood pressure.

Other research suggests that people with high blood pressure are at increased risk of severe COVID illness and death.

What's the Link?

Why people with high blood pressure may be at higher risk for coronavirus is not known. One possibility could be in the relationship between hypertension and the immune system.  Long-term health conditions and aging weaken your immune system so it's less able to fight off the virus. Almost two-thirds of people over 60 have high blood pressure.

Another possibility is that the higher risk comes not from high blood pressure itself, but from certain drugs used to treat it -- ACE inhibitors and angiotensin receptor blockers (ARBs).

This theory may come from research that suggests these types of medications weaken the body’s immune cells.

But other large studies found no ties between the use of these drugs and how severe COVID-19 is. Still other research suggests that they may make COVID-19 less severe. There’s also no proof that people have less severe illness after stopping them.

Stopping these medications may make heart and kidney disease worse. It can also raise your risk of death.

The American College of Cardiology and American Heart Association recommend that you keep taking your high blood pressure medicine as prescribed. If you don’t, it could raise your risk for a heart attack or stroke, putting you in the hospital just as coronavirus cases are coming in.

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How Coronavirus Affects People With High Blood Pressure

While pneumonia is the most common complication of the virus, it can also damage the cardiovascular system. 

High blood pressure damages arteries and reduces the flow of blood to your heart. That means your heart has to work harder to pump enough blood. Over time, this extra work can weaken your heart to the point where it can't pump as much oxygen-rich blood to your body.

Coronavirus can also damage the heart directly, which can be especially risky if your heart is already weakened by the effects of high blood pressure. The virus may cause inflammation of the heart muscle called myocarditis, which makes it harder for the heart to pump.

If you also have plaque buildup in your arteries, the virus may make those plaques more likely to break apart and cause a heart attack. Past studies have shown that people with heart disease who get a respiratory illness like the flu or earlier types of coronavirus are at higher risk for a heart attack.

What Should You Do?

Everyone needs to take precautions to prevent coronavirus. People with high blood pressure and other health conditions need to be extra careful.

The CDC offers this advice:

  • Get vaccinated against COVID-19 from one of the three approved vaccines and check the CDC website to make sure that you are up to date on your vaccine booster shots.
  • Make sure you have enough medicine on hand to treat high blood pressure and other health conditions.
  • Stock up on over-the-counter medicines to treat a fever and other symptoms if you get sick.
  • Stay at home and limit contact with other people as much as you can.
  • Avoid crowds and anyone who looks sick. Wear a face mask if you are indoors in public in communities with substantial or high transmission.
  • Wash your hands often with soap and warm water.
  • Clean and disinfect all frequently touched surfaces like countertops and doorknobs.

 

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on January 28, 2022

Sources

SOURCES:

American College of Cardiology: "ACC Clinical Bulletin Focuses on Cardiac Implications of Coronavirus (COVID-19)," "COVID-19 Clinical Guidance for the Cardiovascular Care Team," "HFSA/ACC/ACA Statement Addresses Concerns Re: Using RAAS Antagonists in COVID-19."

American Heart Association: "How High Blood Pressure Can Lead to a Heart Attack," "What heart patients should know about coronavirus."

CDC: “COVID-19,” "Hypertension Prevalence and Control Among Adults: United States, 2015 – 2016," "Transcript - CDC Media Telebriefing: Update on COVID-19," “COVID-19: How to Protect Yourself & Others,” “Use of Cloth Face Coverings to Help Slow the Spread of COVID-19."

European Society of Cardiology: "Position Statement of the ESC Council on Hypertension on ACE-Inhibitors and Angiotensin Receptor Blockers."

Istitute Superiore di Sanita (ISS): "Report sulle caratteristiche dei pazienti deceduti positivi a COVID-19 in Italia Il presente report è basato sui dati aggiornati al 17 Marzo 2020."

Journal of the American College of Cardiology: "Cardiovascular considerations for patients, health care workers, and health systems during the coronavirus disease 2019 (COVID-19) pandemic."

Mayo Clinic: "Myocarditis."

Science Media Centre: "Expert reaction to questions about high blood pressure, diabetes, and ACE inhibitor drugs, and risk of COVID-19 infection."

The Lancet: "Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?"

UpToDate: “Coronavirus disease 2019 (COVID-19): Issues related to kidney disease and hypertension.”

European Heart Journal: “Association of hypertension and antihypertensive treatment with COVID-19 mortality: a retrospective observational study.”

Bimil Shah, M.D.,Livongo: "Tracking COVID-19’s Effect on the Nation’s High Blood Pressure, Aug 31, 2020."

American Association for the Advancement of Science: “Common Blood Pressure Drugs Leave Immune Cells Weak Against Bacteria.”

BMJ Journals: “Hypertension as an independent risk factor for severity and mortality in patients with COVID-19: a retrospective study.”

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