The World Health Organisation (WHO) has defined Covid-19 as a pandemic. This has set off alarm bells amongst the population known as the “risk group”, which includes those who have cardiovascular problems.
Why does Covid-19 affect those who have heart disease?
The infection caused by Covid-19 puts strain on the heart. It should be highlighted that in patients who have a prior condition such as cardiac insufficiency, it will worsen the function of the heart. This worsening can cause we cardiologists call congestion or accumulation of liquid in the lungs. This situation may complicate breathing and provoke a respiratory infection, considerably increasing the risk of complications.
Apart from putting a strain on the heart, it has been observed that Covid-19 can cause direct infectious and inflammatory damage to the cardiac muscle, which we call myocarditis. Depending on the degree to which the inflammation affects the heart, it may worsen the function of the heart as a pump and, as such, the patient’s prognosis.
The risk of cardiovascular patients contracting this infection depends directly on whether they are exposed to an infected person. It does not seem likely that heart disease facilitates contagion, but what we do have evidence of is that people with cardiovascular disease may have a worse prognosis.
Why does Covid-19 affect elderly people more?
The Lancet has just published an article about the first cases of Covid-19 in China, and they note that the group of patients who suffered a fatal outcome were more likely to suffer from illnesses such as high blood pressure, diabetes mellitus or ischaemic cardiopathology. However, when all the factors were analysed together, advanced age continued to be the one that was most closlely related to an adverse prognosis.
This occurs because elderly patients are immunosuppressed and, along with the existence of a chronic heart condition, it means they have a higher risk of developing complications such as pneumonia and, as a result, of dying of respiratory distress.
That is why it is of vital importance that patients are careful to comply with their treatment, and that they avoid ingesting liquids that they may retain and can destabilise them.
If I have high blood pressure, can I continue taking my medication, or could it have side effects if I get Covid-19?
In relation to antihypertensive treatments, I would like to clarify to patients that recently on social media some people have tried to disseminate incorrect information related to the possible adverse or harmful effect of drugs used to treat high blood pressure and cardiac insufficiency in patients infected by Covid-19 (angiotensin converting enzyme inhibitors [ACE] and angiotensin II receptor blockers [ARB]).
According to the official statement from the Council on Hypertension, the European Society of Cardiology, there is no current evidence to justify the suspension of treatment. As such, I recommend that patients continue taking the medication prescribed to them, and that they raise any concerns they may have with a health professional.