Silent hypertension cases come to the fore since Covid, say docs
Times of India | 17 May 2024
Kolkata: Detection of silent hypertension has gone up sharply since Covid, when it was the most common comorbidity along with diabetes, said doctors on the eve of World Hypertension Day on Friday. While almost half of the patients are unaware of their condition, a significant percentage of these undiagnosed patients have lower immunity and symptoms of cardiac illnesses making them vulnerable to heart attack and brain stroke, they said.
BM Birla Heart Research Centre interventional cardiologist Anjan Siotia said, “Almost all cardiac patients have hypertension and almost half of all hypertension patients are unaware of their condition, which was proved during Covid.Only half of those diagnosed are on medicines and have their blood pressure adequately controlled. The rest either don’t take medicines or are inadequately treated. This section becomes susceptible to consequences of hypertension — brain stroke and heart attack.”.
Patients with hypertension and related issues as comorbidity were more vulnerable during the pandemic, physicians said.
Diabetes and hypertension topped the list of comorbidities, even among young Covid patients, according to Charnock Hospital pulmonologist Soumya Sengupta. “These two conditions worsened Covid in a significant number of patients and continue to be silent killers. Those suffering from obstructive sleep apnoea, which also remains untreated in many, leads to a resistant hypertension that refuses to respond to common drugs. So, along with BP and sugar, sleep patterns also need to be monitored to ensure that sleep apnoea is diagnosed,” said Sengupta.
Hypertension can also be ‘episodic’, which often keeps it undetected, said ILS Hospitals clinical cardiology consultant Prasun Haldar. In many young patients, it keeps fluctuating between day and night. “We often come across patients suspected to be hypertensive but their blood pressure remains normal during consultation or screening. This group is vulnerable to any viral attack apart from heart attack and cerebral stroke. We recommend ambulatory blood pressure monitoring or ABPM, which screens blood pressure for a day and detects fluctuations,” said Haldar, adding sleep apnoea patients tend to have episodes of high pressure at night due to obstruction in oxygen flow.
A recent study says an average Indian has a heart rate of 80, higher than the normal 72, and has a higher blood pressure in the evenings. This should guide the timing of anti-hypertension drugs and dosage. “Both masked and white-coat hypertension — a condition in which BP shoots up at a healthcare provider’s chamber rather than at home — point to a need for round-the-clock monitoring. Intermittent checks often fail to detect fluctuations, which could eventually lead to a heart attack or a cerebral stroke. Most are detected after a brain stroke or a heart attack,” said Fortis Hospital cardiothoracic surgeon K M Mandana.
Autoimmune disorders can also trigger hypertension, which doesn’t respond to ordinary medicines, said Arghya Chattopadhyay, academic dir-ector, Asian Institute of Imm-unology and Rheumatology.