Advice for people managing High Blood Pressure (Hypertension) at home

It is not clear why people with high blood pressure are at a higher risk of developing complications if they contract COVID-19, so it is important to follow all the recommended advice on staying safe and take any heart medication your doctor has prescribed.

You have high blood pressure when your blood pressure readings are more than 140 over 90 consistently over several readings. When on treatment for high blood pressure the target for most people is to have a blood pressure below 130/80mmHg particularly if you have had a cardiac event or stroke; have other risk factors; or have diabetes.

High blood pressure is very common in Ireland and by taking control of your blood pressure you can make a positive step towards reducing your overall risk of having a heart attack or stroke. You can do this following the medical advice you are given by your doctor, having regular check-ups, taking your medication as prescribed and making positive lifestyle changes.

Many people also like to monitor their blood pressure themselves using a home blood pressure monitor. The British & Irish Hypertension Society publishes the only independent, validated blood pressure monitors for home use, not governed by commercial interest. For a list of these validated blood pressure monitors, click here.

The following video outlines how to measure your blood pressure using a validated monitor to ensure it is recorded accurately.

For more information on High Blood Pressure, click here.

 

Advice From Croí, the Heart & Stroke Charity COVID-19 and People Living with Heart Disease

The coronavirus pandemic has caused great alarm and distress across the country. Understandably, many of those living with heart disease are anxious and concerned.

While people of all ages can be infected by this new virus, it presents a greater risk for people over the age of 60 years of age and those who have underlying medical conditions, chief among them is heart disease, high blood pressure and diabetes.

It’s well established that many virus infections can affect the heart, and coronavirus is no different. Viruses are known to cause inflammation of the heart muscle. While in a healthy patient this may not lead to an adverse outcome, the situation for those living with heart disease is different. If these individuals become infected with coronavirus they are at greater risk of adverse cardiac events and the outcomes may be poor.

“It is normal to feel concerned about COVID-19, especially if you are living with heart disease. While it is normal to feel anxious about how this condition might affect you, the first thing to know is that you are at no greater risk of developing COVID-19 than anyone else. However, if you do contract the virus you have a higher chance of developing complications,” says Croí Director of Programmes, Irene Gibson.

With the number of cases in Ireland increasing on a daily basis, hospitals are likely to experience an unprecedented increase in-patient admissions. Consequently, in anticipation some hospitals are cancelling clinics and limiting non-urgent activity to urgent and emergency cases so as to reduce the strain on staffing and beds.

It is important to remember that our hospitals will continue to treat heart patients, but the current pressures may result in delays, cancellations of appointments and disruption of services.

 

How do I reduce my risk of contracting the COVID-19 virus:

For those living with heart disease, prevention is key. Currently, there is no vaccine to prevent COVID-19 and the best way to prevent illness is to avoid being exposed to this virus.

Coronavirus is spread by droplet infection – coughing and sneezing – or by close contact with someone who has the virus. As this is a new illness, we do not know how easily the virus spreads from person to person. Spread is most likely from those who have symptoms. It is very important therefore to limit close contact.

“Croí’s advice is to be extra vigilant and follow the advice of the HSE. Be aware of the symptoms of coranavirus and be extra vigilant in taking the recommended precautionary measures. Everyone has a role to play in reducing the spread of this virus and if we all take collective responsibility we will minimise the risk for everyone,” says Croí CEO, Neil Johnson.

 

Key things to remember are:

  • Stay at home as much as possible and limit your social contact, particularly with people who are unwell.
  • Wash your hands regularly with soap and hot water – do this for at least 20 seconds at each wash.
  • When you cough or sneeze, cover your mouth and nose with a tissue or your sleeve (not your hands). Immediately after use, put your used tissues in the bin and then wash your hands.
  • Do not touch your eyes, nose or mouth if your hands are not clean.
  • Do not share objects that touch your mouth, for example bottles or cups.
  • Do you best to follow all your medical advice on how to keep your condition well controlled.
  • Stay in regular contact with family, friends or neighbours as you may need to ask for help if you become sick.
  • Maintain a healthy diet – unless you have been advised to adhere to a specially prescribed diet, you should continue to try and eat a wide variety of foods that are rich in vitamins, minerals, fibre and other essential nutrients.
  • Try and engage in some form of exercise everyday – even if it is only walking up and down the stairs if you are able.

 

For Family and Caregivers:

  • Know what medications are prescribed – maintain a list.
  • Watch for new symptoms.
  • Prepare a plan to make sure food and other supplies are available when needed.
  • Consider options and have a plan for what would happen if you become ill.

 

International heart specialists are offering the following advice and opinion for specific heart conditions, says Croí

  • Individuals who are immunosuppressed, such as heart transplant patients or cancer patients who also have heart disease and pregnant women with underlying cardiac conditions are probably the most vulnerable to this virus and need to be extra vigilant.
  • There is no evidence to-date that the virus infects implanted devices such as pacemakers and cardioverter defibrillators or causes infective endocarditis (infection) in those with heart valve disease.
  • Individuals with Brugada Syndrome (heart rhythm disorder), need to be mindful of developing high temperatures (above 39 degrees Celsius) and should treat accordingly.
  • Individuals who have previously suffered from myocarditis or pericarditis are not at any higher risk of developing the same condition with COVID-19.
  • To-date there is no evidence that the coronavirus directly infects the heart however the infection caused by the virus may worsen heart function and exacerbate symptoms in patients with heart failure.
  • For the general population, wearing a mask is only recommended if you are experiencing symptoms or caring for someone with symptoms. If you have a heart condition, wearing a mask may make breathing more difficult so you should consult your doctor for advice on this.
  • All those with heart conditions who are on medications should take all their medications exactly as prescribed. Do not make any changes without firstly contacting your doctor or nurse.

Despite all the focus on coronavirus, the usual amount of heart attacks and strokes will continue to occur in our community. It’s important therefore to remind people not to delay if they are experiencing signs or symptoms of heart attack or stroke. If you do experience chest pains or stroke symptoms, please do not delay in calling 999 or 112. The emergency departments are still open for heart and stroke patients in all hospitals.

“While the Croí Heart & Stroke Centre is not currently running face to face classes or programmes, our health team are here as always to answer your questions so please don’t hesitate to reach out to us or visit our website for support resources,” says Irene Gibson, Director of Programmes.

 

You can contact the Croí Health Team on 091-544310 Monday – Friday from 9:00am – 5:30pm or you can email us at healthteam@croi.ie.

The Croí website (www.croi.ie) is regularly updated with the latest advice on COVID-19, along with practical guides and tips to help you achieve a healthy lifestyle.  

FAQs: COVID-19

FAQ

Here are some of the frequently asked questions that our Croí team have covered this week in relation to COVID-19. We will keep this page updated regularly. The Croí Health Team are following National & International best practice guidelines and the advice of the HSE. Learn more at www.hse.ie.

1. Why are older adults and people with chronic health conditions at higher risk of more serious illness if they catch coronavirus COVID-19?

As we age our immune systems grow weaker, which makes it more challenging for older adults to fight off infectious diseases.  Chronic health conditions are more common as we get older. These conditions like heart disease, stroke, lung disease, diabetes, cancer or high blood pressure might mean your immune system isn’t as strong as others when exposed to viruses.

If you have a heart condition the virus could affect your heart in several ways. It is mainly associated with the lungs but if your diseased heart has to work harder to get oxygenated blood throughout the body, it may cause an extra strain. This can worsen problems for people with heart failure, where the heart is already struggling to pump blood efficiently.

2. I’ve heard that high blood pressure or my blood pressure medications could cause more severe Covid-19 infection – should I stop taking my blood pressure tablets?

It is always important to take any heart medication your doctor has prescribed, and even more so when you are at risk of being exposed to the COVID-19 virus. By taking your medication, you can better protect your heart, which can help protect you against complications of COVID-19 if you do get it.

It has been suggested, especially on social media sites, that commonly used medications (see list below) used to treat high blood pressure and certain heart conditions may increase the risk of infection and the severity of COVID-19. Because of this, patients taking these drugs for their high blood pressure and their doctors have become increasingly concerned, and, in some cases, have stopped taking their medications.

It is important to highlight that this information is speculation and does not have a sound scientific basis or evidence to support it. Best practice guidelines from the European Society of Cardiology Council on Hypertension strongly recommend that physicians and patients should continue treatment with their usual anti-hypertensive therapy.

Blood pressure medications:

  • Angiotensin converting enzyme inhibitors (ACE-i)
    • common examples include Capoten (captopril), Tritace (ramapril), Coversyl (perindopril), Vasotec (enalapril) Prinivil, Zestril (lisinopril) Lotensin (benazepril)
  • Angiotensin Receptor Blockers (ARBs)
    • common examples include Atacand (candesartan), Teveten (eprosartan), Micardis (telmisartan), Diovan (valsartan), Cozaar (losartan), Benicar (olmesartan)

3. I have a chronic heart condition… What can I do to reduce my risk?

For heart and stroke patients, prevention is key. If you are in an at-risk group or caring for someone in an at-risk group, you should follow the HSE general advice on how to protect yourself from coronavirus.

Cocooning is now recommended for all individuals aged 70 and over or those who have underlying medical conditions, visit the cocooning section of our website to see if you fall into this category. If you are not advised to cocoon you should still stay at home as much as possible, only leaving the house when needed such as to attend medical appointments or for food shopping. For further information, see our COVID-19 advice page. In addition to the general advice, do your best to keep your condition well-controlled. That means:

  • Follow your doctor’s advice including taking medications as directed.
  • If possible, get a 90-day supply of your prescription medications so you don’t have to go regularly to the pharmacy to pick them up.
  • Have a plan for if you do get sick
    • Watch your health for new symptoms
    • Stay in touch with family, friends, neighbours as you may need to ask for help if you become sick
    • Have a backup plan for who can care for you if your caregiver gets sick
  • If you are family/caregiver
    • Know what medications are prescribed and make sure supplies are on hand
    • Have a backup plan to make sure food and other supplies needed are available
    • Determine who can take over if you become sick