Deborah Chen | Managing hypertension in the COVID era

Today is World Hypertension Day. This year’s theme is ‘Measure Your Blood Pressure Accurately, Control It, Live Longer’, focusing on combating low awareness rates worldwide and accurate blood pressure measurement methods. Persons living with hypertension need to properly manage their condition.

The drastic spread of coronavirus has wreaked much havoc on global healthcare systems. Not only is the raging spread and highly transmissible nature of the virus a concern, government officials and healthcare professionals alike have been highlighting its detrimental impacts on vulnerable populations. While we are still learning about the virus, and trying to encourage vaccination, several global health organisations have reiterated that based on currently available information and clinical expertise, older adults and people of any age who have serious underlying medical conditions might be at higher risk for severe illness from COVID-19.

HYPERTENSION AND COVID-19

Hypertension, as defined by the American Heart Association, is when the blood pressure, the force of blood pushing against the walls of the blood vessels, is consistently too high. It is one of the most common risk factors for major cardiovascular issues, including heart attack and stroke, while predisposing persons to other health complications, such as kidney disease, heart failure and dementia. The risk factors for hypertension, such as unhealthy diets and low levels of physical activity, continue to increase in Jamaicans 15 years and older. The COVID-19 pandemic has led many people to forego follow-up and treatment of chronic health conditions such as hypertension, and it is now quite evident that people living with the chronic non-communicable disease are also more likely to develop severe complications from the coronavirus.

According to the Centers for Disease Control and Prevention (CDC), the magnitude of hospitalisations and deaths amongst persons of certain populations, including African Americans, living with hypertension, has been drastically high. While vulnerability to severe complications of COVID is highest among older patients, regardless of race or ethnicity and socio-economic circumstance, according to the National Bureau of Economic Research, “Vulnerability based on pre-existing conditions collides with long-standing disparities in health and mortality by race-ethnicity and socio-economic status.” Approximately half of COVID-19-related deaths in Jamaica have occurred in patients with cardiovascular disease.

Some health experts have alluded that a weaker immune system is one of the few reasons people with hypertension and other health problems are at higher risk for severe complications from the coronavirus. These long-term health conditions and ageing weaken the immune system, hence its decreased ability to ward off the virus. Nearly two-thirds of people over 60 have high blood pressure.

HYPERTENSION MANAGEMENT

With these stark findings and as we try to navigate the new realities presented by COVID-19, where do we go from here? Heart health is a number one priority of The Heart Foundation of Jamaica. With the current onset of COVID-19, our efforts to protect persons with heart complications have increased. You don’t know the health of your heart, or even overall health status, until you check it out. Hence, adults, especially those 65 and older and those living with vulnerable conditions, are implored to do regular screenings, including blood pressure checks, screening for heart disease, blood glucose and cholesterol. A person will never know how well they will be able to withstand the stress of the virus unless they have checked, and work with their doctor to optimise their heart/vascular health.

With the seeming non-stop in incidences of COVID-19, Jamaicans are urged to practise heart healthy measures to help safeguard themselves and further curb the rates of infection. Amongst these measures are proper nutrition, mental and physical health:

- Eat a variety of nutritious foods from all the food groups. You may be eating plenty of food, but your body may not be getting the nutrients it needs to be healthy. Nutrient-rich foods have minerals, protein, and other nutrients, but are lower in calories. Foods, including fresh fruits, vegetables, low-fat dairy, legumes and nuts, skinless poultry and fish, help to create a more healthful dietary pattern for persons living with cardiovascular disease.

- Cut back on beverages and foods with added sugars.

- Eat less salt by cutting down on table salt, salted meats, sauces. Aim for one teaspoon salt per day or half teaspoon if you have high blood pressure.

- Consume a diet rich in whole grains, nuts, and healthy fats, such as in olive, sesame, peanut or other oils rich in unsaturated fatty acids. Such diets may support your immune system and help to reduce inflammation.

- Limit alcohol intake.

- Stop smoking. Smoking cigarettes leads to diseases of the heart and blood vessels and increases the complications of hypertension. The CDC warns that smokers are likely to be more vulnerable of COVID-19 as the virus compromises the lungs, further reducing its functioning capacity.

- Exercise regularly. Be more active, aiming for at least 30 minutes of exercise daily.

- Read your food labels so that you can limit the purchase and consumption of food high in fat, salt and sugar.

- Take care of your mental health and reduce stress by doing things that relax you.

- The American College of Cardiology and American Heart Association recommend that you keep taking your high blood pressure medicine as prescribed. If you don’t, it could raise your risk for a heart attack or stroke, putting you in the hospital just as coronavirus cases are coming in.

As uncontrolled blood pressure continues to surge in our local population, and as the pandemic continues to disrupt the management of chronic health conditions, this may serve as a prime opportunity for us to purposefully change the current trends in hypertension and implementing long-term policy solutions.

Deborah Chen is the executive director of The Heart Foundation of Jamaica. Send feedback to ghapjm@gmail.com