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How Much Does High Blood Pressure Impact COVID Severity?

person with a blood pressure cuff on arm. high blood pressure can influence COVID risk

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Key Takeaways

  • A study from the U.K. showed a correlation between elevated blood pressure and the risk of severe COVID.
  • If you have high blood pressure, taking measures to get it under control is one way to reduce your risk of hospitalization and death from COVID.

A new study is quantifying just how much having high blood pressure can influence COVID-19 risk.

Researchers from the University of Cambridge in the United Kingdom found that people with high blood pressure are 22% more likely to develop severe COVID—defined as being hospitalized or dying from COVID—than those whose blood pressure is in a healthy or normal range.

The findings highlight the importance of blood pressure control for all individuals as one measure you can take to protect yourself against severe COVID.

“This study highlights the importance of minimizing your cardiovascular and COVID risks,” Joseph Ebinger, MD, assistant professor of cardiology at Cedars-Sinai in Los Angeles, told Verywell. He was not involved in the study. “We are living with COVID, and controlling your risk factors is your best way to stay healthy in the long run. High blood pressure should be controlled because when left untreated, it increases the risk of [health] events, heart-related and not heart-related, in the future.”

How Much Did High Blood Pressure Impact COVID Outcomes?

Nearly half of U.S. adults are living with high blood pressure. In the U.K., high blood pressure only affects about one in three people—a lower ratio that was reflected in this study’s participant pool.

Researchers collected data from 16,134 COVID-positive individuals in the U.K. Biobank, a voluntary database of health records in the U.K. Of the surveillance sample, 6,517 had a prior diagnosis of essential hypertension, which is a blood pressure of 130/80 or higher that can’t be attributed to a different condition.

Ninety to 95% of people with hypertension in the United States have essential hypertension, also called primary hypertension. This type of high blood pressure is rooted in genetic, environmental, or lifestyle causes.

Among the sample pool, the more poorly controlled a person’s blood pressure was, the greater their risk for severe COVID. In fact, those with a systolic blood pressure of 150-159 had a 91% greater chance of severe COVID than individuals with a systolic blood pressure of 120-129.

What Your Blood Pressure Numbers Mean

Your blood pressure reading is comprised of two numbers: your systolic blood pressure (the top number), and your diastolic blood pressure (the bottom number). Your systolic blood pressure is the force against your arteries when your heart beats, pushing blood out to your organs and tissues. Ideal systolic blood pressure should be less than 120. Your diastolic blood pressure is the remaining tension in your arteries while your heart is at rest between beats. Ideally, it should be less than 80.

Researchers controlled for other known factors that increase the likelihood of severe COVID, including age, sex, weight, ethnicity, smoking history, diabetes, and socioeconomic status.

This study only included data until early 2021, so the impact of high blood pressure on COVID cases caused by the Omicron variant remains undefined.

Why High Blood Pressure Can Cause Severe COVID

According to Ebinger, high blood pressure is associated with several health conditions; it’s not unique to COVID-19.

“We know that high blood pressure is exceedingly common and it seems to accompany other conditions such as stroke and heart attack,” Ebinger said. “Even when researchers control for these factors, they find patients with high blood pressure are still at higher risk for many illnesses.”

Another thing we know is that high blood pressure damages blood vessel walls, making them more prone to damage. Ebinger said that the body responds to this damage by triggering inflammation, a significant player in severe COVID illness. Many of the inflammatory markers the body creates worsen COVID severity because they lead to widespread organ failure.

The Problem? COVID Is Also the Cause of High Blood Pressure

Some evidence suggests that a lack of access to primary care services during the pandemic may have led to the undertreatment of chronic conditions, including high blood pressure, in high-risk individuals.

“Our understanding of COVID-19 was very limited at that time, and with little to no treatment options or available vaccine. It’s my opinion that patients were avoiding medical care out of fear of contracting the virus during their visits,” Jasmin Valentin, MD, a telehealth provider with Sameday Health, told Verywell. “Today, [in-person] medical visits are still roughly one-third of what they were pre-pandemic. As a result of this delay in care, providers are now caring for patients with more severe health complications, including those with hypertension.”

First Steps Toward Maintaining a Healthy Blood Pressure

Managing high blood pressure does not always require visiting your doctor’s office. In many cases, you may be able to discuss treatment strategies on a video call.

“It remains vitally important to continue to support and develop the robust infrastructure of telemedicine availability and remote patient monitoring,” Nicole Harkin, MD, FACC, a preventative cardiologist and founder of Whole Heart Cardiology in San Francisco, told Verywell. “Pandemic or not, these are important advances that allow us to better care for those with chronic diseases.”

Harkin emphasized that lifestyle changes, including implementing a heart-healthy diet, getting sufficient exercise, managing stress, and getting adequate sleep are the first steps to managing high blood pressure. If these strategies do not reduce blood pressure sufficiently, then medications may be an option.

Among study participants who were taking blood pressure medication, it did not appear that one type was more effective than another at preventing severe COVID outcomes.

Researchers split patients into two subgroups: those who took either angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), and those who took other blood pressure medications, such as beta blockers. They found no difference in COVID outcomes based on the type of blood pressure medication the patient was taking.

One drawback of the study is that the population looked at was relatively small and heterogeneous. A more extensive study, known as the AIM-HY-INFORM clinical trial, is already underway at the University of Cambridge, which will include a more ethnically diverse patient population.

What This Means For You

All individuals, even those without high blood pressure, should consider being vaccinated against COVID-19, as that is the most effective method of preventing severe COVID at this time. But if you have high blood pressure, being vigilant about any measures you can take to get it under control is one critical step to reducing your risk of severe COVID. Getting your blood pressure under control is not only vital to COVID risk, but it is also vital to overall health.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Pavey H, Kulkarni S, Wood A, et al. Primary hypertension, anti-hypertensive medications and the risk of severe COVID-19 in UK Biobank. PLOS ONE. 2022;17(11). doi:10.1371/journal.pone.0276781

  2. Centers for Disease Control and Prevention. Facts about hypertension.

  3. Boston Children’s Hospital. How COVID-19 triggers massive inflammation.

  4. Hartnett KP, Kite-Powell A, DeVies J, et al. Impact of the COVID-19 pandemic on emergency department visits — United States, January 1, 2019–May 30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(23):699-704. doi:10.15585/mmwr.mm6923e1

By Cyra-Lea Drummond, BSN, RN
 Cyra-Lea, BSN, RN, is a writer and nurse specializing in heart health and cardiac care.