Malaysia recorded 6,976 new Covid-19 cases on May 23, 2021, the highest number of daily cases reported since the start of the pandemic. The number of Covid-19 deaths and severe cases which require intensive care have also increased tremendously.
From May 1 to 21, Malaysia lost a total of 643 people, close to one-third of all Covid-19 deaths in the country since the pandemic started. Within the same period, patients admitted to the ICU increased by 91 per cent (from 337 to 643) and patients requiring ventilation support doubled from 176 to 363.
Covid-19 has negatively impacted the care of patients with non-communicable diseases such as hypertension and diabetes mellitus. Hypertension is the most common pre-existing medical condition among Covid-19 patients globally, as well as in Malaysia.
Patients with hypertension are 95 per cent more likely to require ICU admission and 160 per cent more likely to succumb to the disease.
A local study reported that 49 per cent of patients with severe Covid-19 had hypertension, compared to 13 per cent within mild cases. The high prevalence of hypertension (three in every 10 adults) in Malaysia means that a substantial proportion of our adult population is at risk.
The adherence and compliance to medication is crucial. Stopping antihypertensive medications could lead to poor blood pressure control, which in turn can result in adverse cardiovascular events such as heart attack, stroke, or kidney failure. All these are linked to poor Covid-19 outcome.
In addition, once the virus enters the body, it could lead to overactivation of the immune system, resulting in a cytokine storm, further burdening the cardiovascular and respiratory system which is already in a suboptimal state.
These probably explain why hypertension is the most common comorbidity among Covid-19 patients, especially among those who had severe infection.
Maintaining a healthy blood pressure (below 140 mmHg/90 mmHg for systolic/diastolic respectively) is important. Take these steps to control your blood pressure:
- Know your blood pressure levels. Check and monitor them regularly. This is important to see whether the efforts to control blood pressure are sufficient or should be improved.
- Limit salt intake in your diet according to the daily recommendations. This can be achieved by carefully inspecting food labels on the content of salt and sodium, avoiding preserved and processed foods, and replacing salts with herbs and spices in cooking.
- Keep your body weight within the normal range. For people who are overweight, a weight loss of three to nine per cent from the current body weight has been shown to reduce the blood pressure reading by three to six mmHg.
- Exercise consistently. Regular aerobic types of physical exercises such as brisk walking and jogging of at least 150 minutes in a week are recommended, as it is beneficial for the cardiovascular system and can lower blood pressure.
- Quit smoking and avoid alcohol, as both activities have been shown to increase one’s blood pressure.
- Comply with your current medications and follow-up appointments if you are hypertensive. Be assured that the medications are safe. Do not hesitate to contact your doctor if you are in doubt about your blood pressure control or medications.
Apart from the abovementioned efforts to control blood pressure, hypertensive patients must follow the standard operating procedures (SOPs) and make every effort to protect oneself from contracting Covid-19.
Dr Nor Afiqah Nordin, Dr Ang Swee Hung, Prof Dr Moy Foong Ming, and Prof Dr Noran Naqiah Hairi are from the Public Health Department, University of Malaya Medical Centre.
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