Coronavirus: What to be aware of if you have high blood pressure
The severity of COVID-19 mainly depends on people’s age and whether they already have other medical conditions.
Based on what is currently known, coronavirus infections are also usually mild in people who have high blood pressure.
Does high blood pressure increase the risk of complications?
There is currently no evidence that COVID-19 is more severe in people who have high blood pressure than in those who have normal blood pressure. But some people who have high blood pressure also have other medical problems that can make the infection more severe.
More research is needed in order to determine whether the degree of high blood pressure (e.g. only slightly high or very high) plays a role.
Should you carry on taking your medication?
People who have high blood pressure or other cardiovascular diseases (affecting their heart and/or blood vessels) should continue to take their medication as agreed with their doctor. This is also true for ACE inhibitors and sartans (angiotensin receptor blockers, or ARBs).
The European Medicines Agency (EMA) and the medical societies in Europe and the U.S. have issued recommendations about this. They advise people taking ACE inhibitors or sartans to do the following:
- Continue with the treatment as discussed with your doctor.
- Always talk to your doctor before adjusting your treatment or starting other treatments.
- Keep your blood pressure under control.
- If you have any questions, phone the doctor’s office.
- Continue to go for important check-ups.
ACE inhibitors and sartans are prescribed for the treatment of various cardiovascular diseases. As well as high blood pressure, these include coronary artery disease and heart failure. Many studies have shown that they work: They can prevent heart attacks, strokes and kidney damage.
Possible risks not confirmed
A few studies on rats led to the concern that coronavirus infections might be more severe in people who take ACE inhibitors or sartans. But other animal experiments have suggested that these medications could have a protective effect instead. You can’t draw reliable conclusions on the effects in humans based on animal experiments alone, though. What's more, the doses used in the animals were far higher than the doses typically used in humans.
A current analysis of several studies done in humans shows that people who take ACE inhibitors or sartans did not have an increased risk of becoming infected with the coronavirus. They also were not at greater risk of having more severe cases of the infection.
What can you do for your health now?
People who have high blood pressure can do a lot of things for their own health. Possible ways to lower your blood pressure include:
- Eating less salt.
- Getting more exercise – for instance, going on a 30-minute walk every day.
- Losing a bit of weight – even a few kilos can reduce your blood pressure.
It's also a good idea to limit the amount of alcohol you drink. Drinking too much alcohol can increase the risk of heart problems such as atrial fibrillation (an irregular heartbeat). Quitting smoking can improve the health of a smoker’s heart.
People who have high blood pressure can protect themselves from the virus by following the same hygiene rules as everyone else. There is no evidence to suggest that having high blood pressure increases your risk of catching COVID-19.
What should I do in an emergency?
Even during the coronavirus crisis, it's important to take medical emergencies seriously. The necessary health care services are still available to everyone. If you suspect that someone is having a heart attack, stroke or other serious complications, you should immediately call the emergency services (112 in Germany and most other European countries, 911 in the U.S.) – just as you always would.
American Heart Association (AHA), Heart Failure Society of America HFSA), American College of Cardiology (ACC). Patients taking ACE-i and ARBs who contract COVID-19 should continue treatment, unless otherwise advised by their physician. March 17, 2020.
European Medicines Agency (EMA). EMA advises continued use of medicines for hypertension, heart or kidney disease during COVID-19 pandemic. March 27, 2020.
European Society of Cardiology (ESC). Position Statement of the ESC Council on Hypertension on ACE-Inhibitors and Angiotensin Receptor Blockers. February 13, 2020.
European Society of Hypertension (ESH). Statement of the European Society of Hypertension (ESH) on hypertension, Renin-Angiotensin System (RAS) blockers and COVID-19. April 15, 2020.
Mackey K, King VJ, Gurley S, Kiefer M, Liederbauer E, Vela K, Sonnen P, Kansagara D. Risks and Impact of Angiotensin-Converting Enzyme Inhibitors or Angiotensin-Receptor Blockers on SARS-CoV-2 Infection in Adults. A Living Systematic Review. Ann Intern Med 2020; 15 May.
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