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Is high blood pressure a risk factor for COVID-19?

Medically reviewed by Drugs.com Last updated on Mar 31, 2020.

Official Answer

by Drugs.com
  • 6% of people with high blood pressure (hypertension) who contract COVID-19 are expected to die, compared with a 2.3% case fatality rate for the population overall
  • People with high blood pressure are thought to be at increased risk of developing COVID-19 and having a worse outcome
  • 76.1% of people who have died from COVID-19 in Italy had high blood pressure

Investigating the risks COVID-19 poses to people with high blood pressure

Researchers are working to understand the specific risks that COVID-19 poses to people with cardiovascular disease, which is an umbrella term that includes conditions such as high blood pressure (hypertension). One such group of researchers has found that high blood pressure was more common in COVID-19 patients who developed heart injury (also known as myocardial or cardiac injury). Of the 82 patients who developed heart injury in a study conducted in 416 patients hospitalized with COVID-19 in China, 59.8% had hypertension. 

The study identified heart injury as being a common complication in patients who developed COVID-19, with 19.7% of patients in the study developing it. Concerningly, it also appears to be a deadly complication as 51.2% of the patients who developed heart injury died, compared with only 4.5% of the patients who did not show signs of heart injury. 

People with high blood pressure appear to be at increased risk from COVID-19

On March 17, 2020, the National Institute of Health in Italy released a report stating that 99% of patients with COVID-19 who had died in Italy had a pre-existing condition. More specifically, 76.1% of the patients who died in Italy had high blood pressure.

The Chinese Centers for Disease Control has published case reports that are reported to indicate people with pre-existing conditions, including hypertension, are at increased risk of developing severe COVID-19. Studies from China that have already been published in the scientific literature report that:

  • Of the 11 patients who died in an initial retrospective study of 99 hospitalized COVID-19 patients, 3 had high blood pressure. 
  • Of the 138 hospitalized COVID-19 patients studied in another case series, 31.2% had high blood pressure. A total of 36 of the 138 patients studied required intensive care unit (ICU) care and 58.3% of those patients had high blood pressure.   
  • Data from another 1099 patients with COVID-19 treated in hospital showed that 23.7% of the 173 COVID-19 patients with severe disease had high blood pressure. 
  • Analysis of data from 140 patients with COVID-19 who were admitted to hospital found that 30% had high blood pressure

CDC recommendations for those at higher risk from COVID-19

The US Centers for Disease Control and Prevention (CDC) recommends that people at higher risk of severe illness from COVID-19 should do the following:

  • Stay at home 
  • Avoid close contact with others (stay 6 feet away from people who are sick)
  • Wash your hands often
  • Clean and disinfect surfaces that are touched frequently
  • Avoid cruise and non-essential air travel
  • Call their health care provider if they have concerns about COVID-19 and their pre-existing condition or they are sick
References
  1. Shi S, Quin M, Shen B, et al. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA Cardiol. Published online March 25, 2020. doi:10.1001/jamacardio.2020.0950.
  2. American College of Cardiology. COVID-19 Clinical Guidance For the Cardiovascular Care Team. [Accessed March 31, 2020]. Available online at: https://www.acc.org/latest-in-cardiology/features/~/media/Non-Clinical/Files-PDFs-Excel-MS-Word-etc/2020/02/S20028-ACC-Clinical-Bulletin-Coronavirus.pdf.
  3. Business Insider Australia. 10 Common health conditions that may increase risk of death from the coronavirus including diabetes and heart disease. March 24, 2020. [Accessed March 31, 2020]. Available online at: https://www.businessinsider.com.au/hypertension-diabetes-conditions-that-make-coronavirus-more-deadly-2020-3?r=US&IR=T.
  4. Chen N, Zhou M, Dong X, et at. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395: 507–13. https://doi.org/10.1016/ S0140-6736(20)30211-7.
  5. Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-1069. doi:10.1001/jama.2020.1585.
  6. Guan W-J, Ni Z-Y, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020. https://www.nejm.org/doi/10.1056/NEJMoa2002032.
  7. Centers for Disease Control and Prevention (CDC). Coronavirus Disease 2019 (COVID-19). What You Can Do. [Accessed March 31, 2020]. Available online at: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/what-you-can-do.html.

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