What people with high blood pressure need to know about COVID-19

Many people have concerns about staying healthy during the COVID-19 pandemic. Those with a chronic condition such as high blood pressure—a reading above 130/80—may face an increased risk for severe complications if they get the virus.

With nearly half of Americans dealing with high blood pressure, the American Heart Association, the world's leading nonprofit organization focused on heart and brain health for all, is sharing information about the risks as the situation rapidly evolves.

What is the real risk?

Based on what we know today, elderly people with coronary heart disease or high blood pressure may be more susceptible to the coronavirus and more likely to develop more severe symptoms. That means it's vital to follow guidance about keeping other conditions well controlled and maintaining good health and hygiene.

Data from the outbreak in Wuhan, China[ii], shows a 10.5% death rate among people with COVID-19 who also have cardiovascular disease, 7.3% for those with diabetes, 6.3% for those with respiratory disease, 6% for those with high blood pressure and 5.6% for those with cancer.

Could blood pressure-lowering medicines make people with COVID-19 sicker?

According to the latest guidance from the American Heart Association, Heart Failure Society of America and the American College of Cardiology, issued March 17,2020:

Do not stop taking prescribed angiotensin converting enzyme inhibitors (ACE-i) or angiotensin receptor blocker (ARB) medications for high blood pressure, heart failure or heart disease.

• These medications don't increase your risk of contracting COVID-19. They are vital to maintaining your blood pressure levels to reduce your risk of heart attack, stroke and worsening heart disease.
• If you're a cardiovascular disease patient with COVID-19, your health care provider should evaluate you before adding or removing treatments. Changes should be based on the latest scientific evidence and shared decision-making.

Caution is key

Some common habits or over-the-counter medicines and supplements can be "BP raisers."

Over-the-counter medications. Common pain medicines called NSAIDs (e.g., naproxen and ibuprofen) can increase your blood pressure. Decongestants are also known BP-raisers. People with heart concerns should limit or avoid them, especially if their blood pressure is uncontrolled. Drugs such as acetaminophen are less likely to increase blood pressure. People should ask their doctors about OTC medicines.

Some prescription medicines. People taking medication for mental health, corticosteroids, oral birth control, immunosuppressants and some cancer medications, should monitor blood pressure to make sure it's under control.

Alcohol and caffeine. People should limit both, because too much can raise blood pressure. Caffeine should be capped at three cups per day in general, and most people with high blood pressure should avoid it.

Herbs and food combinations. "Natural" supplements and home remedies might not be safe. Some herbal supplements, such as licorice, can raise blood pressure.

Connecting with health care providers and pharmacist

• Patients should ensure they have enough prescription medications to last for a prolonged period or see if they can get a larger supply than normal.
• Mail-order systems may be available for people who can't or don't want to leave home.
• Medications should be taken exactly as prescribed. Decreasing or stopping them could raise blood pressure to dangerous levels. People with concerns should talk to a doctor or pharmacist.

Keep follow-up appointments. Some doctor's offices offer virtual visits when possible

Getting support. The American Heart Association's free online Support Network offers support for those with similar conditions or health concerns.

Emergencies don't stop for COVID-19

High blood pressure increases the risk for heart attack and stroke. Certain heart and stroke symptoms require immediate medical intervention, and every second matters. Calling 9-1-1 at the first sign of heart attack, stroke, or cardiac arrest saves lives. Fast access to medical treatment is the No. 1 factor for surviving a cardiovascular event.

Additional resources:

• Access high blood pressure tools and resources.
• As COVID-19 cases increase, preventing a second heart attack or stroke is vital.
• Get the latest American Heart Association information and recommendations on COVID-19.
• Centers for Disease Control and Prevention information and resources for COVID-19.