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High blood pressure is a known risk factor for an episode of Covid-19 severe enough to raise the specter of hospitalization and death. In fact, research has shown that high blood pressure doubles the risk of having a severe case of Covid, even if you are fully vaccinated and boosted.
Blood pressure is measured in units of millimeters of mercury (abbreviated as mmHg), which consists of two numbers – an upper or systolic reading which represents the maximum pressure in your arteries, and the lower or diastolic reading which shows the pressure in your arteries when your heart muscle is resting between beats.
But what is considered high enough blood pressure to trigger this risk? To this day, scientists are not sure. Now, a new study from England published Wednesday in the journal PLOS One has answered that question.
“We found that in people with diagnosed hypertension, the risk of Covid-19 increased significantly once the high number exceeded 150 mmHg or the low number exceeded 90 mmHg relative to a target blood pressure (120-129 /80-89 mmHg),” lead author Holly Pavey, a PhD student at the University of Cambridge in the UK, funded by the British Heart Foundation, said by email.
Research has found that people with this level of uncontrolled high blood pressure are more likely to be admitted to hospital and die from Covid infection, regardless of other known risk factors such as age, ethnicity or obesity.
The new study was able to go deeper and be more specific because of the inherent integration with the UK’s National Health Service. This level of data sharing allows access to “really granular data about their patients’ long-term blood pressure control,” said Dr. Joseph Ebinger, assistant professor of cardiology and director of clinical analytics at Smidt Heart. Institute at Cedars-Sinai. Los Angeles Medical Center.
“They found that it’s not just the diagnosis of high blood pressure — yes or no — but the risk goes up as your systolic blood pressure goes up, which is really a measure of lack of control,” he said. Ebinger, who was not involved in the study.
Unfortunately, many people fail to properly control their blood pressure, even after being diagnosed and on medication, Ebinger added.
“It’s estimated that less than half of people diagnosed with high blood pressure actually have their hypertension under control, so that’s a big deal,” he said. “This is due to a myriad of factors: underdiagnosis, lack of awareness, medication nonadherence, and undertreatment.”
On the positive side, successful lowering of blood pressure through medication was linked to a corresponding reduction in the risk of severe Covid, according to the new study.
“It’s really important for individuals to have regular blood pressure checks and for doctors to try to control their patients’ blood pressure,” Pavey said.
“Controlling blood pressure to target levels is important regardless of the type of therapy used to achieve it,” she said. “Ultimately, controlling blood pressure will help reduce the risk of becoming seriously ill from new strains of Covid-19 or other viruses in the future.”
Blood pressure readings can be confusing – there are a lot of numbers floating around and medical professionals haven’t really made it easy to keep track of people.
“Normal” blood pressure readings are usually 120 mmHg systolic (upper reading) over 80 mmHg dystolic (lower reading), according to the US Centers for Disease Control and Prevention.
This is probably the number you will hear mentioned most often. However, that might not be the number your doctor uses to treat you, Ebinger said.
Doctors used to aim for blood pressure below 140/90 to control the risk of cardiovascular disease and death, he explained. Then, in 2015, results from SPRINT, or the Systolic Blood Pressure Intervention Trial, were published in the New England Journal of Medicine – results that changed the way of thinking for many medical professionals.
SPRINT research found that targeting blood pressure below 120 systolic (the highest figure) in people with hypertension — but not diabetes — prevented most cases of heart disease and death. There were, however, some side effects, including a “higher rate of acute kidney injury or acute kidney failure in the intensive treatment group,” according to the trial.
This possibility was concerning for the elderly, who often suffer from several chronic diseases such as type 2 diabetes, kidney problems, etc., Ebinger said.
“So in 2017, the American College of Cardiology and American Heart Association guidelines closed the gap and established the guideline of a systolic reading below 130 and a diastolic reading below 80,” Ebinger said. “And that’s where some of the debate starts to come up between different types of doctors. I’m a cardiologist, and we think a drop is better. We want to bring that number down as much as possible.
“Some primary care physicians and geriatricians might say, ‘You know what, that might not be the best thing for some of my patients,’ and they’re going to treat a higher number,” he said. . “So that’s where the clinical practice and some of the guidelines don’t always add up.”
Here are the current medical guidelines, according to the U.S. Food and Drug Administration:
- A typical normal blood pressure is 120/80 or less.
- Readings between 120/80 and 129/89 are considered pre-hypertension, meaning they are not as low as they should be, but are not yet considered hypertension medically.
- Blood pressure is a stage 1 red flag if it reads 130/80.
- A blood pressure of 140/90 or higher is considered stage 2 hypertension.
If your blood pressure is 180/110 or higher more than once, get medical help right away. A lecture at this high level, there is a “hypertensive crisis,” the FDA said.
At the end of the line ? Take your blood pressure often (here’s how to do it correctly) and see your doctor regularly.
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