Doctors warn against discontinuing blood pressure medicines during COVID19

By Rajeev Khanna*
Amid the COVID19 outbreak in India, it is the exceptionally large community of high blood pressure or hypertension patients that stands out among the most vulnerable. Medical experts say that the number of hypertension patients in the country is more than 30 per cent of the total population.
They have emphatically underlined that these patients cannot afford non-compliance with the prescribed treatment for hypertension as it will further strain the healthcare systems already stretched to full capacity by the ongoing pandemic.
According to a spokesperson of Post Graduate Institute of Medical Education and Research (PGIMER) at Chandigarh:
“Hypertensive patients are at the highest risk of becoming dangerously sick or dying due to corona virus, experts have warned. Even as the medical fraternity rushes to put in place effective and credible treatment protocols to curb the global pandemic, some recent studies have suggested that ACE inhibitors ( class of medication used primarily for the treatment of high blood pressure and heart failure) and ARBs ( first-line antihypertensives) commonly used to treat blood pressure could aggravate the symptoms of COVID19 infection.
“Clearing the air on the matter, global public health experts and medical practitioners from premier institutions across the country have emphatically stated that it is too early to draw such conclusions and non-adherence to treatment could be dangerous.”
Dr Yash Paul Sharma, who is heading the Department of Cardiology at PGIMER said people with hypertension are indeed at a higher risk of catching the corona virus. Citing a recent systematic review and meta-analysis that appeared in ‘International Journal of Infectious Diseases’ that assessed the prevalence of co-morbidities in COVID19 infected patients, Dr Sharma observed that hypertensive patients with the underlying disease were more at risk in severe cases as compared to non-severe patients.
He added that COVID19 patients had a fatality rate of 8.4%, 13.2%, 9.2%, 8% and 7.6% in those with hypertension, cardiovascular diseases, diabetes, chronic respiratory diseases and cancer, respectively. “As such, avoiding blood pressure medications is a big risk that we in India cannot afford to have as our healthcare systems are already stretched because of the COVID19 spread,” he stressed.
Dr Sonu Goel of Department of Community Medicine and School of Public Health at the same institute highlighted the need of monitoring other risk factors such as tobacco use.
The PGIMER spokesperson went on to quote Dr Tom Frieden of Resolve to Save Lives which is an initiative of global public health organization Vital Strategies saying that evidence from around the world shows that people with hypertension should not forego their regular medicines. According to Dr Frieden:
“As we respond to the COVID19 pandemic, we need to protect and provide care for the most vulnerable among us, including people living with cardiovascular disease and other chronic diseases. People with hypertension and other chronic disease are more likely to become seriously ill and die from the virus. That’s why it’s more urgent than ever that people in India and around the world can access the medication they need, either through telemedicine, multiple month prescriptions or other safe methods.” The spokesperson said that the World Health Organisation (WHO) and the Centers for Disease Control and Prevention (CDC) have issued special warnings to safeguard those with chronic health conditions. A recent report in the "China Daily" stated that 50 percent of the 170 patients, who died in Wuhan in January, had hypertension or other non-communicable diseases.

China Daily reports, 50% of 170 patients who died in Wuhan in January had hypertension and other non-communicable diseases

Although such claims are yet to be clinically substantiated, a WHO-China joint mission on the COVID19 outbreak has revealed similar findings. Top doctors from Wuhan, the ground zero of COVID19 have also corroborated that almost 50% of those dying from the disease were hypertensive.
The PGIMER spokesperson further quoted Prof Suneela Garg of Indian Association of Preventive and Social Medicine saying:
“Globally there are firm protocols in place that have been tested and are followed to treat hypertension. These depend on the age of the person, duration of being hypertensive and existence of co-morbidities, to name some. The current guideline being followed by physicians and practitioners across the globe is to continue hypertensive medications even while being treated for corona virus led infection.
“Hypertensive persons are best advised, in addition to their blood pressure medication, to follow non-pharmacological approaches such as taking up yoga, stress management and low calorie intake to keep their blood pressure levels under check.” Dr Tiny Nair who is another well-known cardiologist based at Thiruvananthapuram has stated that five prominent societies including European Society of Hypertension (ESH), European Society of Cardiology Council of Hypertension, Hypertension Canada, Renal Association UK, and Canadian Cardiovascular Society have independently announced that there is no data to withhold the important medicines for patients of hypertension in the background of emergence of COVID19.
He underlined, “For those millions of people of hypertension, controlled on these medicines, stopping blood pressure drugs on unfounded fear might create a far more dangerous situation than COVID itself.”
---
*Senior journalist based in Chandigarh and Solan (Himachal Pradesh)

Comments

A comrade in culture and controversy: Yao Wenyuan’s revolutionary legacy

By Harsh Thakor* This year marks two important anniversaries in Chinese revolutionary history—the 20th death anniversary of Yao Wenyuan, and the 50th anniversary of his seminal essay "On the Social Basis of the Lin Biao Anti-Party Clique". These milestones invite reflection on the man whose pen ignited the first sparks of the Great Proletarian Cultural Revolution and whose sharp ideological interventions left an indelible imprint on the political and cultural landscape of socialist China.

1857 War of Independence... when Hindu-Muslim separatism, hatred wasn't an issue

"The Sepoy Revolt at Meerut", Illustrated London News, 1857 By Shamsul Islam* Large sections of Hindus, Muslims and Sikhs unitedly challenged the greatest imperialist power, Britain, during India’s First War of Independence which began on May 10, 1857; the day being Sunday. This extraordinary unity, naturally, unnerved the firangees and made them realize that if their rule was to continue in India, it could happen only when Hindus and Muslims, the largest two religious communities were divided on communal lines.

N-power plant at Mithi Virdi: CRZ nod is arbitrary, without jurisdiction

By Krishnakant* A case-appeal has been filed against the order of the Ministry of Environment, Forest and Climate Change (MoEF&CC) and others granting CRZ clearance for establishment of intake and outfall facility for proposed 6000 MWe Nuclear Power Plant at Mithi Virdi, District Bhavnagar, Gujarat by Nuclear Power Corporation of India Limited (NPCIL) vide order in F 11-23 /2014-IA- III dated March 3, 2015. The case-appeal in the National Green Tribunal at Western Bench at Pune is filed by Shaktisinh Gohil, Sarpanch of Jasapara; Hajabhai Dihora of Mithi Virdi; Jagrutiben Gohil of Jasapara; Krishnakant and Rohit Prajapati activist of the Paryavaran Suraksha Samiti. The National Green Tribunal (NGT) has issued a notice to the MoEF&CC, Gujarat Pollution Control Board, Gujarat Coastal Zone Management Authority, Atomic Energy Regulatory Board and Nuclear Power Corporation of India Limited (NPCIL) and case is kept for hearing on August 20, 2015. Appeal No. 23 of 2015 (WZ) is filed, a...

Spirit of leadership vs bondage: Of empowered chairman of 100-acre social forestry coop

By Gagan Sethi* This is about Khoda Sava, a young Dalit belonging to the Vankar sub-caste, who worked as a bonded labourer in a village near Vadgam in Banskantha district of North Gujarat. The year was 1982. Khoda had taken a loan of Rs 7,000 from the village sarpanch, a powerful landlord doing money-lending as his side business. Khoda, who had taken the loan for marriage, was landless. Normally, villagers would mortgage their land if they took loan from the sarpanch. But Khoda had no land. He had no option but to enter into a bondage agreement with the sarpanch in order to repay the loan. Working in bondage on the sarpanch’s field meant that he would be paid Rs 1,200 per annum, from which his loan amount with interest would be deducted. He was also obliged not to leave the sarpanch’s field and work as daily wager somewhere else. At the same time, Khoda was offered meal once a day, and his wife job as agricultural worker on a “priority basis”. That year, I was working as secretary...

Two more "aadhaar-linked" Jharkhand deaths: 17 die of starvation since Sept 2017

Kaleshwar's sons Santosh and Mantosh Counterview Desk A fact-finding team of the Right to Feed Campaign, pointing towards the death of two more persons due to starvation in Jharkhand, has said that this has happened because of the absence of aadhaar, leading to “persistent lack of food at home and unavailability of any means of earning.” It has disputed the state government claims that these deaths are due to reasons other than starvation, adding, the authorities have “done nothing” to reduce the alarming state of food insecurity in the state.

Fate of Yamuna floodplain still hangs in "balance" despite National Green Tribunal rap on Sri Sri event

By Ashok Shrimali* While the National Green Tribunal (NGT) on Thursday reportedly pulled up the Delhi Development Authority (DDA) for granting permission to hold spiritual guru Sri Sri Ravi Shankar's World Culture Festival on the banks of Yamuna, the chief petitioners against the high-profile event Yamuna Jiye Abhiyan has declared, the “fate of the floodplain still hangs in balance.”

Proposed Modi yatra from Jharkhand an 'insult' of Adivasi hero Birsa Munda: JMM

Counterview Desk The civil rights network, Jharkhand Janadhikar Mahasabha (JMM), which claims to have 30 grassroots groups under its wings, has decided to launch Save Democracy campaign to oppose Prime Minister Narendra Modi’s Vikasit Bharat Sankalp Yatra to be launched on November 15 from the village of legendary 19th century tribal independence leader Birsa Munda from Ulihatu (Khunti district).

Ground reality: Israel would a remain Jewish state, attempt to overthrow it will be futile

By NS Venkataraman* Now that truce has been arrived at between Israel and Hamas for a period of four days and with release of a few hostages from both sides, there is hope that truce would be further extended and the intensity of war would become significantly less. This likely “truce period” gives an opportunity for the sworn supporters and bitter opponents of Hamas as well as Israel and the observers around the world to introspect on the happenings and whether this war could have been avoided. There is prolonged debate for the last several decades as to whom the present region that has been provided to Jews after the World War II belong. View of some people is that Jews have been occupants earlier and therefore, the region should belong to Jews only. However, Christians and those belonging to Islam have also lived in this regions for long period. While Christians make no claim, the dispute is between Jews and those who claim themselves to be Palestinians. In any case...

Epic war against caste system is constitutional responsibility of elected government

Edited by well-known Gujarat Dalit rights leader Martin Macwan, the book, “Bhed-Bharat: An Account of Injustice and Atrocities on Dalits and Adivasis (2014-18)” (available in English and Gujarati*) is a selection of news articles on Dalits and Adivasis (2014-2018) published by Dalit Shakti Prakashan, Ahmedabad. Preface to the book, in which Macwan seeks to answer key questions on why the book is needed today: *** The thought of compiling a book on atrocities on Dalits and thus present an overall Indian picture had occurred to me a long time ago. Absence of such a comprehensive picture is a major reason for a weak social and political consciousness among Dalits as well as non-Dalits. But gradually the idea took a different form. I found that lay readers don’t understand numbers and don’t like to read well-researched articles. The best way to reach out to them was storytelling. As I started writing in Gujarati and sharing the idea of the book with my friends, it occurred to me that while...

Counterview

Search This Blog