High blood pressure, also known as hypertension, is a widespread health concern affecting millions globally. This condition is characterized by the force of blood against artery walls being consistently too high, which can increase the risk of serious health complications like heart disease and stroke. In the wake of the COVID-19 pandemic, some individuals have reported experiencing changes in their blood pressure, including the development of new high blood pressure or the worsening of existing hypertension. This observed phenomenon warrants a closer look to understand its implications for public health.
Understanding the Connection
Research and clinical observations have indicated a link between COVID-19 infection and the development or exacerbation of high blood pressure. A study published in Hypertension, analyzing over 45,000 individuals, found a significant association between SARS-CoV-2 infection and the emergence of persistent high blood pressure, even in those without a prior history of the condition. This correlation was particularly evident in specific demographics, including individuals aged 40 and above, men, and Black adults.
New-onset hypertension post-COVID-19 is notable. For instance, 21% of hospitalized COVID-19 patients and 11% of non-hospitalized cases developed elevated blood pressure, according to one analysis. In comparison, hospitalized influenza patients saw a 16% rate, and non-hospitalized influenza cases had a 4% rate of similar outcomes. These findings underscore a public health challenge, emphasizing the need for post-COVID-19 hypertension screening, especially for at-risk patients.
How COVID-19 May Affect Blood Pressure
COVID-19 can influence blood pressure through several physiological pathways. A primary aspect is the virus’s interaction with the renin-angiotensin-aldosterone system (RAAS). SARS-CoV-2 gains entry into host cells by binding to the angiotensin-converting enzyme 2 (ACE2) receptors, which are abundant in various organs, including the heart and blood vessels. This binding can lead to a downregulation of ACE2, resulting in an imbalance within the RAAS.
The infection can also induce widespread endothelial dysfunction, affecting the inner lining of blood vessels. This dysfunction can hinder vasodilation and increase vascular resistance, contributing to elevated blood pressure. COVID-19 often triggers a significant inflammatory response and a “cytokine storm.” These inflammatory agents directly impact blood vessel health and contribute to blood pressure dysregulation.
Kidney involvement during COVID-19, termed COVID-19-Associated Nephropathy (COVAN), also plays a role. Acute kidney injury, local inflammation, and microthrombi in the kidneys can disrupt their ability to regulate fluid and electrolyte balance, contributing to blood pressure changes. The body’s stress response during and after infection, including sympathetic nervous system overactivation, also contributes to blood pressure elevation.
Managing Blood Pressure Post-COVID
Managing high blood pressure after COVID-19 is important. Regular blood pressure monitoring is important, as hypertension often presents without noticeable symptoms until complications arise. All adults over 18 years of age should measure their blood pressure regularly, either at home or in a pharmacy setting. If systolic readings exceed 140 mm Hg or diastolic readings exceed 90 mm Hg, consulting a healthcare professional is advised.
Lifestyle adjustments also contribute to managing blood pressure. Adopting a healthy diet low in salt, increasing intake of potassium-rich foods, and limiting alcohol consumption are helpful. Regular physical activity, aiming for at least 30 minutes of moderate exercise daily, lowers blood pressure and maintains overall cardiovascular health. Managing stress through techniques like mindfulness or meditation, ensuring adequate sleep, and maintaining a moderate weight are also advised.
Seek personalized medical attention for diagnosis and treatment. A healthcare professional can assess individual circumstances, provide tailored advice, and determine if medication adjustments or new prescriptions are necessary. Continuing prescribed medications for existing hypertension, such as ACE inhibitors or angiotensin receptor blockers, unless advised otherwise by a physician, is important.