HYDERABAD:
Hypertensive patients are at the highest risk of becoming dangerously sick or dying due to coronavirus, experts have warned.
Even as the medical fraternity rushes to put in place effective and credible treatment protocols to curb the global pandemic, some recent studies have suggested that ACE inhibitors and ARBs commonly used to treat blood pressure could aggravate the symptoms of COVID-19 infection. Clearing the air on the matter, global public health experts and medical practitioners from premier institutions across the country have emphatically stated that it is too early to draw such conclusions and non-adherence to treatment could be dangerous.
Dr Tom Frieden, President and CEO, Resolve to Save Lives, an initiative of Vital Strategies said that evidence from around the world shows that people with hypertension should not forego their regular medicines.
“As we respond to the COVID-19 pandemic, we need to protect and provide care for the most vulnerable among us, including people living with cardiovascular disease and other chronic diseases. People with hypertension and other chronic disease are more likely to become seriously ill and die from the virus. That’s why it’s more urgent than ever that people in India and around the world can access the medication they need, either through telemedicine, multiple month prescriptions or other safe methods,” Dr Frieden added.
The World Health Organisation (WHO) and the Centers for Disease Control and Prevention (CDC) have issued special warnings to safeguard those with chronic health conditions. A recent report in the China Daily stated that 50 percent of the 170 patients, who died in Wuhan in January, had hypertension or other NCDs. Although such claims are yet to be clinically substantiated, a WHO-China joint mission on the COVID-19 outbreak has revealed similar findings. Top doctors from Wuhan, the ground zero of COVID-19 have also corroborated that almost 50% of those dying from the disease were hypertensive.
In India, where at least a 30% of the people have high blood pressure, non-compliance with the prescribed treatment for hypertension, will further strain the healthcare systems already stretched to full capacity by the ongoing pandemic. Prof Suneela Garg, National President Elect, Indian Association of Preventive and Social Medicine, said, “Globally there are firm protocols in place that have been tested and are followed to treat hypertension. These depend on the age of the person, duration of being hypertensive and existence of co-morbidities, to name some. The current guideline being followed by physicians and practitioners across the globe is to continue hypertensive medications even while being treated for coronavirus-led infection.”
Dr Garg, who is also the Professor and Head, Community Medicine of Maulana Azad Medical College & Associated Hospitals added, “Hypertensive persons are best advised, in addition to their blood pressure medication, to follow non-pharmacological approaches such as taking up yoga, stress management and low calorie intake to keep their blood pressure levels under check.”
Dr Yash Paul Sharma, Professor and Head, Department of Cardiology, PGIMER, Chandigarh, said people with hypertension are indeed at a higher risk of catching the coronavirus.
Citing a recent systematic review and meta-analysis that appeared in the International Journal of Infectious Diseases that assessed the prevalence of co-morbidities in COVID-19 infected patients, Dr Sharma observed that hypertensive patients with the underlying disease were more at risk in severe cases as compared to non-severe patients. He added that Covid-19 patients had fatality rate of 8.4%, 13.2%, 9.2%, 8% and 7.6% in those with hypertension, cardiovascular diseases, diabetes, chronic respiratory diseases and cancer, respectively.
“As such, avoiding blood pressure medications is a big risk that we in India cannot afford to have as our healthcare systems are already stretched because of the COVID-19 spread,” he stressed.
Dr. Sonu Goel, Professor, Department of Community Medicine and School of Public Health, PGIMER, Chandigarh highlighted the need of monitoring other risk factors such as tobacco use.
Well-known Thiruvananthapuram-based cardiologist, Dr Tiny Nair said, “Five prominent societies, including European Society of Hypertension (ESH), European Society of Cardiology Council of Hypertension, Hypertension Canada, the Renal Association UK, and Canadian Cardiovascular Society have independently announced that there is no data to withhold the important medicines for patients of hypertension in the background of emergence of COVID.”
Dr. Nair who heads the cardiology department at the reputed PRS Hospital in Kerala’s capital, added, “For those millions of people of hypertension, controlled on these medicines, stopping BP drugs on unfounded fear might create a far more dangerous situation than COVID itself.”
Ashim Sanyal, COO of Delhi-based Consumer VOICE that works for consumer rights and welfare, said there is no reason for panic buying in the country as the government has repeatedly assured that there will be no shortage of essential supplies, including medicines, in the country.
“However, hypertensive patients can avoid frequent visits to the pharmacy and thus unwittingly expose themselves to the coronavirus infection. They can stock up a 90-day supply of prescribed anti-hypertensive medications,” he advised.
