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Infectious Diseases

Updated 09 June 2020

Covid-19 patients with high blood pressure face higher risk of death, study says

Having high blood pressure could double the risk of death in people who become infected with Covid-19, according to a new study.

  • More than 1 billion people worldwide suffer from hypertension
  • New research shows hypertension patients with Covid-19 have a doubled risk of mortality
  • Health professionals urge patients to continue taking their medication

High blood pressure, medically known as hypertension, is a serious medical condition that affects an estimated 1.13 billion people worldwide, according to the World Health Organization (WHO) – most of them in low- and middle-income countries.

According to new research published this month in the European Heart Journal, patients with this condition have a double risk of dying from Covid-19, the disease caused by the new coronavirus, than patients without it.

Hypertension patients 'should take good care of themselves'

The study was carried out by researchers in China and Ireland who looked at data from 2 866 patients with Covid-19. The patients were admitted to Huo Shen Shan hospital in Wuhan, China, earlier this year. Out of these patients, 850 presented with a medical history of high blood pressure.

The researchers found that 34 out of 850 patients (4%) with Covid-19 died, compared to 22 out of 2 027 (1.1%) patients without hypertension. This was after they took into account factors that may have affected the results, such as age, sex and other medical conditions.

Among patients with hypertension who were not taking their medication, 11 out of 140 (7.9%) died, compared to 23 out of 710 (3.2%) patients who were taking medication. Researchers stressed that this only highlights that neglecting medication for hypertension places patients at an even higher risk of death due to Covid-19.

"It is important that patients with high blood pressure realise that they are at increased risk of dying from Covid-19. They should take good care of themselves during this pandemic and they need more attention if they are infected with the coronavirus,” said Professor Fei from Xijing Hospital, reported EurekAlert.

RAAS inhibitors do not increase risk of death

"There were 140 patients admitted to hospital with Covid-19 who had discontinued their anti-hypertensive treatment due to various reasons. We found that this was associated with a greater risk of dying from the coronavirus,” Li said.

The team looked at additional data from almost 2 300 patients in three other studies. Through a meta-analysis, they intended to analyse the death rates in these patients and determine whether patients being treated with medication to control blood pressure levels which targets the renin-angiotensin-aldosterone system (RAAS) can increase the risk of mortality.

Their findings revealed a lower risk of death among 183 patients that were treated with RAAS inhibitors, compared to 527 patients who were treated with other medication to control their blood pressure levels.

"In contrast to our initial hypothesis, we found that RAAS inhibitors, such as ACE inhibitors or angiotensin receptor blockers, were not linked to an increased risk of dying from Covid-19 and, in fact, may be protective,” Li said.

However, the researchers wrote that it is too early to make clinical recommendations based on these results, and that randomised controlled clinical trials (RCT) will offer better insight into the role played by RAAS inhibitors.

Health24 recently reported on another study, published in the New England Journal of Medicine in May, wherein researchers looked at the link between treatment with four drug classes for hypertension, and an increased risk of severe Covid-19. Their results proved that there is no link between substantial risk of severe Covid-19 (such as intensive care, use of a ventilator, or death) among patients and certain, common classes of antihypertensive medications. 

Patients urged to continue medication

The Heart and Stroke Foundation South Africa notes that 225 South Africans are killed by heart disease every day and that 13% of global deaths are caused by hypertension. An estimated 42% to 54% of South Africans were suffering from hypertension in 2018, Health-E News reported.

Minister of Health, Dr Zweli Mkhize said in a media release last month that data for patients who had been hospitalised with Covid-19 showed that hypertension, diabetes and cardiac disease are the three most common comorbidities associated with serious illness from Covid-19, and urged South Africans who live with these conditions to take extra precaution during this time.