Resurgence of hypertension and cardiovascular diseases in patients recovered from COVID-19: An Indian perspective

Abstract

Objective: The aim of this study was to understand the prevalence, extent, clinical approach of hypertension and cardiovascular disease (CVD) in patients recovered from COVID-19. Methods: The round table meetings (RTMs) and survey convened a diverse panel of specialists including cardiologists, endocrinologists, diabetologists, consultant physicians, and family physicians from various geographical zones of India. A standard questionnaire including 10 questions was developed pertaining to the resurgence of hypertension and CVD in patients recovered from COVID-19. The RTMs and survey were held virtually. The collected opinions and recommendations were compiled to derive a consensus document. Results: A total of 3066 health-care practitioners (HCPs) participated. Hypertension was the most prevalent comorbidity in patients recovered from COVID-19 followed by diabetes, dyslipidemia, and coronary artery disease. Almost two-thirds of HCPs reported that 10%–30% newly diagnosed hypertension in patients recovered from COVID-19. Uncontrolled hypertension in 10-20% of COVID-19 recovered patients opined by 45% of the HCPs. About, 35% HCPs reported CV complications in 10-20% of Covid-19 recovered patients and 63% HCPs reported exacerbations of CAD in 10-30% of patients. Majority of HCPs preferred to switch to dual combination therapy from monotherapy for hypertension management (52.0%) and ARBs and its combination is most preferred combination for hypertension control (60%). Majority of the HCPs suggested follow-up after 1-2 weeks (39.0%). Close monitoring on symptoms including chest pain and breathlessness (45.0%), adherence to medication and regular monitoring of lab parameters (25%) is recommended for these patients. Conclusion: Overall observations indicate an increased incidence of hypertension and CVDs post recovery from COVID-19. A dual therapy of ARBs was the preferred choice for management of hypertension. Regular follow-up and close monitoring of symptoms to prevent further CV complications in COVID-19 recovered patients is recommended.

Harnessing nutritional immunity and advanced diagnostics for COVID-19 prevention

“…Among COVID-19 patients, there is an increased susceptibility to developing venous thromboembolism and arterial thrombotic events, which can subsequently manifest as strokes, heart attacks, or pulmonary embolisms. Additionally, some COVID-19 patients experience exacerbations of preexisting hypertension or the onset of new hypertension, along with the observation of arrhythmias such as atrial fibrillation (Tudoran et al, 2022;Re et al, 2022;Krishnakumar et al, 2022).…”

“…Research has also revealed the likelihood of post-acute sequelae in some COVID-19 survivors, including chronic myocarditis and cardiomyopathies. COVID-19 has a complex effect on the cardiovascular system, covering direct viral impacts, inflammatory processes, endothelial dysfunction, and thrombotic tendencies (Krishnakumar et al, 2022;Elseidy et al, 2022;Santoro et al, 2023).…”

Arterial Hypertension and Covid-19: Possible Relationship

“…Исследование, в котором приняли участие 3066 врачей первичного звена Индии, выявило, что до 20% выздоровевших от COVID-19 пациентов имеют неконтролируемую гипертензию [43]. Почти 52% медицинских работников для контроля АД у пациентов с АГ, перенесших COVID-19, перешли с монотерапии на двойную комбинацию, 20% увеличили дозу двойной терапии и 13% использовали тройную терапию [43].…”

InSH Consensus Guideline for the Management of Hypertension, 2023

“…COVID-19 exerts a significant impact on the cardiovascular system, giving rise to complications like acute coronary syndrome, myocardial infarction, fluctuations in blood pressure, and the exacerbation of pre-existing cardiovascular diseases. 251 Studies consistently highlight that hypertension and cardiovascular diseases are the most prevalent co-existing conditions in individuals afflicted with COVID-19. 252,253 The association likely involves the dysregulation of the RAAS and ACE2 system, along with the strain caused by acute lung injury, which increases the workload on the heart.…”