Covid-19 advice for high blood pressure patients

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Covid-19 advice for high blood pressure patients
16/03/2020

Among changing advice surrounding coronavirus (COVID-19) and how to stay safe, please find our Blood Pressure UK advice for people with high blood pressure below.

This page was last updated on 2 June and we will keep it regularly updated. Please also see the NHS, Public Health England and the BBC for live updates.

CORONAVIRUS (COVID-19) ADVICE FOR HIGH BLOOD PRESSURE PATIENTS TAKING ACE INHIBITORS (ACEi) OR ANGIOTENSIN RECEPTOR BLOCKERS (ARBs)

Some social media sites and newspapers have suggested that some commonly-used drugs including ACE inhibitors (which have names ending in ‘pril” e.g. ramipril, lisinopril, perindopril) and ARBs (which have names ending in ‘sartan’ e.g. losartan, candesartan, valsartan) may increase both the risk of infection and the severity of SARS-CoV2 (the virus causing coronavirus). This has led to some people with high blood pressure (hypertension) stopping their medication, which could lead to harmful consequences such as a decline in blood pressure control, heart failure or stroke.

These concerns about the safety of ACE inhibitors and ARBs in relation to coronavirus are speculated and, without a sound scientific basis to support them, we recommend that you should continue with your usual treatment. It is very important that your blood pressure remains controlled. 

Blood Pressure UK Trustee Professor Bryan Williams has examined the data on ACE inhibitors and ARBs in relation to COVID-19 and found no increased risk of contracting the virus or of admission to hospital or severe complications. The analysis was published on May 14 in The Lancet.  

This recommendation is also in line with statements from The International Society of Hypertension (ISH), the Council on Hypertension of the European Society of Cardiology, and the European Society of Hypertension. It is also in line with the Government's statement on ACE inhibitors and ARBs released on 27 March.

This advice is not tailored to individuals so follow the advice of your doctor.  

Note that this advice applies to people taking these drugs for heart failure, high blood pressure, diabetes or kidney disease. 

We will update you if new evidence comes to light and this advice changes.

ADVICE FOR EVERYONE WITH RAISED BLOOD PRESSURE 

Professor Graham Macgregor, Chairman of Blood Pressure UK explains: “As far as we are aware, people with high blood pressure are not more likely to catch coronavirus or have a more severe reaction to it, but as this is a new virus the evidence is not entirely clear and will continue to evolve, so please err on the side of caution. If you have a long-term medical condition such as heart disease or diabetes, the coronavirus could be more serious if you do catch it. We will let you know if any more evidence comes to light, and in the meantime, take good care to reduce the risk of catching or spreading the virus.  

"If you have fever, cough and difficulty breathing, please seek medical attention and inform your healthcare professional that you are taking medication for high blood pressure.” 

We advise people with raised blood pressure to follow the Government advice issued for everyone to follow to reduce the risk of catching or spreading the virus. These steps are particularly important if you are over 70 or have an underlying health condition, including heart disease or diabetes. The full guidelines are available from the NHS and PHE

Our chairman Professor Graham MacGregor, and researchers we work with, have reviewed the evidence around COVID-19 and risk factors linked to it. In the two largest studies conducted so far (until May 18), one using UK Biobank data and includes nearly half a million people, and the other using NHS health records including 17.4 million people) high blood pressure was not significantly associated with a higher risk of COVID-19 hospitalisation or death. This is after adjustment for potential confounding factors which could skew the results.   

In other words, blood pressure does not seem to play a role in the severity of a COVID-19 infection according to the evidence available so far. 

Note these papers are preprints and have not yet been peer reviewed. We will keep this page up to date with any changes. 

Stay at home 
Stay at home and only go out for essential shopping or for exercise, and only travel to work if essential – even if you aren't self-isolating. This is to avoid spreading the virus between households to avoid the NHS becoming overwhelmed.

Wash your hands frequently
Regularly and thoroughly clean your hands with an alcohol-based hand rub or wash them with soap and water for 20 seconds or more.

Avoid touching your eyes, nose and mouth

Practice respiratory hygiene
Make sure you, and the people around you, follow good respiratory hygiene. This means covering your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately. Try to wear a face mask in public, particularly in busy places 

If you have fever, cough and difficulty breathing, seek medical care early
Self-isolate if you feel unwell. If you have a fever, cough and difficulty breathing, seek medical attention and call in advance. Please inform your healthcare professional that you are taking medication for high blood pressure. Use phone, online services, or apps to contact your GP surgery or other NHS services (rather than going in person). Follow the directions of your local health authority.

Do seek medical help for other problems, and call 999 for emergencies 
Our blood pressure helpline is open to all during this time. Reach us by phone on 020 7882 6218 or by email at help@bloodpressureuk.org You can also contact your GP or other NHS services. It's important to get medical help for health problems even if they're not related to coronavirus. 

Dial 999 for emergencies including if you think you might be having a stroke or a heart attack - even if you're not sure. See the signs of a heart attack and signs of stroke from the NHS. 

Keep monitoring your blood pressure at home as normal
If you monitor your blood pressure at home, keep going as normal. Learn more about home monitoring.  

Stay healthy while staying home 
Look after your physical and mental wellbeing with these tips to take care of all aspects of your health.  

TAKE PARACETAMOL RATHER THAN IBUPROFEN  
There is also speculation about the use of ibuprofen. The evidence here is also evolving and the sensible advice appears to be not to take ibuprofen unless necessary. Instead, use paracetamol for symptoms of coronavirus. Stick within the safe limits which you will find on the leaflet that comes with the tablets.

With all best wishes during this worrying time,

Blood Pressure UK



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