COVID-19 and Hypertension

For the millions of Americans with hypertension, social distancing has also meant distancing from their health care providers. COVID-19 infection may be more serious among patients with hypertension. To make matters worse, most doctors offices are closed and many are scared to go to the hospital.
What is the relationship between COVID-19 and hypertension?
The virus enters human cells through a cell receptor called ACE-2. This receptor plays a key role in regulating blood pressure in the body. Hypertensive patients can have more of these receptors in the body, leading to more severe infection.
Should I change my blood pressure medications?
The short answer is no. Some suggest that a class of mediation called ACE inhibitors increase the amount of ACE-2 receptors in the body, making patients more prone to serious infection. However, this has not been validated. We don’t know whether stopping this medication protects against the virus. We do know that stopping blood pressure medications can raise blood pressure and put patients at risk of complications such as heart attack or stroke.
To do that, first make sure you have a blood pressure cuff. Today’s technology is accurate enough that using a digital wrist cuff can get a good blood pressure reading, Delgado-Lelievre said.
Next, rest in a sturdy chair for at least five minutes, making sure to sit with your back straight. Keep your forearms supported on a flat surface such as a table, and keep the blood pressure cuff placed directly above where your elbow bends.
As you’re monitoring blood pressure over time, make sure to take the readings at the same time every day.
Any blood pressure reading of 120 over 80 is considered elevated, Delgado-Lelievre said.
Moving up from that point, the first level of hypertension is defined as 130 or higher for systolic (the top number) and 80 or higher for diastolic (the lower number), according to the American Heart Association.
My doctors office is closed. How can I manage my blood pressure?
Social distancing has complicated the doctor-patient relationship. While there is no consensus, many practices such as my own have transitioned to telephone or video visits during this crisis. I can get a lot of information about my patients by simply seeing them and speaking with them.
I do recommend that hypertensive patients check their blood pressure regularly. My practice offers a home blood pressure monitor. The results are sent directly to my computer via the internet. If this is not an option, blood pressure cuffs can be purchased from your local pharmacy.
When should I go to the hospital?
Hypertension is considered an emergency when the blood pressure is greater than 180/110 and accompanied by symptoms such as persistent headache, confusion, shortness of breath, chest pain or dizziness. Many patients are hesitant to go to the emergency room for fear of exposure to COVID-19. However, in the setting of a true hypertensive emergency, treatment should not be delayed
If you have any further questions or needs, schedule a virtual telehealth visit from the safety and comfort of your home
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The African American community is at higher risk
It’s not just adults over 60; African Americans are also at a higher risk for hypertension, according to a study published in the Journal of the American Heart Association.
U.S. Surgeon General Jerome Adams told “CBS Sunday Morning” that he has high blood pressure, noting “I have heart disease, and I and many black Americans are at higher risk for COVID,” he said.
CNN political commentator Van Jones echoed Adams.
“All the doctors are saying: people who have high blood pressure and hypertension are very at risk to dying when they get this virus,” Jones said. “Nobody is saying that to the black community loudly enough.”
For groups more likely to have co-morbid conditions or other risk factors, including African Americans and the elderly, Jones had blunt advice.
“What that means is if your grandmother has high blood pressure or diabetes, grab her and pull her into the house and do not let her out for two months,” he said.