Hypertension during Covid-19

Author : Dr S. Venkatesh, Lead Consultant, Interventional Cardiology, Aster RV Hospital

India

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New Delhi, June 10, 2020 :

Dr. S. Venkatesh, Aster RV

As the COVID-19 pandemic sweeps the globe, reports are pouring in from several countries that patients with hypertension, diabetes and heart disease are among the hardest hit by the SARS-CoV2 virus. It is just about the right time for us to know a little about hypertension and it’s prevention in the light of the pandemic.

Hypertension, or high blood pressure runs deep in the veins of India. A chronic condition and one of the most common lifestyle diseases, hypertension is characterised as blood pressure (BP) recording of 140 over 90 mmHg on several occasions over a period of time. It was earlier thought to be a disease of the elderly, however that narrative has now changed. More and more younger people are developing hypertension in recent times. It is estimated that one out of every 5 young Indians and 1 out of every 3 adults in India suffer from this condition. Incidentally, India also has among the highest burden of diabetes in the world; diabetics are also at a higher risk of developing hypertension compared to non-diabetics; it appears that  2 out of every 3 diabetics eventually develop high BP as well.

It is very common for high BP to go unnoticed until a complication develops, such as a stroke, heart failure or kidney disease, earning this dread disease the epithet, the silent killer.

Early detection and management of your hypertension

Identifying hypertension early is important because at this stage, it is possible to control it or even completely reverse it, thereby preventing any further damage. As alluded to, high BP can be entirely asymptomatic. However, certain symptoms do suggest a person could be having high BP. These are recurrent headaches, especially in the back of the head, blurred vision, nausea, heart palpitations, breathing difficulty, nosebleed etc. If there is a history of high blood pressure in your family or you experience any of the above symptoms, it is important to seek a doctor’s advice.. More often, hypertension is detected on routine check or during an unrelated medical examination. Therefore, it is suggested that everyone above 25 years of age should check BP at least once a year.

Remedial Measures

Lifestyle factors play a major role in the development of hypertension. An increase in unhealthy food habits, physical inactivity, high levels of stress, increased use of tobacco and alcohol, all of these contribute towards it. All these lifestyle factors are potentially correctable. During these uncertain times during the COVID-19 pandemic, it is advisable to adhere to a healthy lifestyle and to inculcate these for the times beyond the pandemic.

Pay attention to the following :

• Diet dilemma: Refined carbohydrates are associated with obesity and diabetes mellitus. There is sufficient evidence that avoiding highly processed foods that contain refined carbohydrates and/or excessive salt can prevent early onset of hypertension. IN the times of Covid-19 people have been found to stock up on processed, easy to cook foods as well as snacks. Consumption of these in excess amounts will lead to worsening of diabetes, add to weight gain and unmask hypertension in those who are prone for it. Increased intake of natural food items rich in fibre, potassium and calcium such as vegetables, some fruits and dairy products is also associated with prevention of hypertension
• Avoid falling into the inactivity trap. Quite often, we postpone exercise and physical activity for tomorrow which never comes! Make exercise a routine. During the time of Covid pandemic, going out due to restrictions or the need for social distancing further reduces the opportunity to exercise. Take the stairs often. Online streaming services are providing free aerobic exercise classes such as aerobics, yoga, dancing and Zumba. Take advantage of these and find fun ways to exercise and feel its positive physical and mental benefits. Again, these healthy habits can be continued beyond the time of the pandemic.
• Deal with stress and anxiety. The current epidemic has generally heightened stress levels. Uncertainty regarding the coronavirus disease, economic shutdown leading to financial difficulties, job loss, stress of dear ones being elsewhere during the pandemic and increased negativity on social and mainstream media about the pandemic are responsible for the increased stress. Identify signs of stress or depression in yourself or those around you. Find methods to deal with stress. If need be, speak to a therapist. Understand that there are coping strategies to help you stay calm, level-headed and give your best even in difficult situations. Make use of this time to address these concerns. Try meditation and breathing exercises.
• Dealing with unhealthy habits. Increased stress as well as being idle due to the lockdown has led to an increase in tobacco consumption. Once the restriction on alcohol sales was removed a rebound increase in consumption of alcohol has also been noted. Both these habits are detrimental to hypertension in particular and a healthy life in general. Avoid these habits.

Why this is all so important.

Long-standing hypertension narrows walls of the arteries making it difficult for blood to flow freely. This not only affects the heart, but also the brain, eyes and kidneys. Heart attacks, heart failure, brain haemorrhage, stroke, kidney failure can all result from poorly controlled hypertension.

A genuine effort to bring in lifestyle changes, regular monitoring of BP and strict adherence to medicine will result in immense long-term benefits, not only to beat hypertension but to keep several lifestyle illnesses at bay and improving the overall quality of life. This time of the pandemic is an ideal one for us to re-examine our lives and make a commitment to ourselves to healthy living!

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