People with high blood pressure who contract COVID-19 must be vigilant about watching, and knowing, their readings.

The reason: It seems some patients will need to stop their blood pressure medications if their blood pressure drops dangerously low. When that happens, the condition, called hypotension, can damage kidneys. It also can be fatal.

This finding was one of three studies on COVID-19 and blood pressure presented at the American Heart Association’s virtual conference held earlier this month. Another study verified that the most common chronic disease that hospitalized COVID-19 patients had in common was high blood pressure, followed by diabetes. A third study, albeit with a smaller, probably more seriously ill group of hospitalized patients, found that those patients taking angiotensin-converting enzyme inhibitors (ACE) and angiotensin receptor blockers (ARBs) had a higher risk of dying prematurely than those who weren’t taking these medicines.

Chances of Survival

In the hospitalization study, researchers wanted to know which COVID-19 patients were most likely to incur kidney damage. Patients with mild hypotension were twice as likely to die when they arrived at the emergency department, regardless of COVID-19 severity, their age or other diseases. The study included nearly 400 patients hospitalized over six weeks at a medical center in Italy.

“When people get really sick, and they’re septic with infection, a lot of times their blood pressure will drop and if you’re on blood pressure medicine to begin with, that drop can be profound,” said Kathryn A. Boling, MD, a family medicine physician at Mercy Medical Center in Baltimore.

Low BP Also a Risk

In the ACE-ARB study, 172 patients were hospitalized for COVID-19 at the University of Miami/JFK Medical Center in Atlantis, Fla. Of the patients who were taking ACE inhibitors or ARBs for high blood pressure, 33% died. Of those who weren’t taking those medicines, 13% died. Patients who were on these blood pressure medicines also ended up in intensive care more often (28% versus 13%) than those patients not taking these medications.

Jennifer Nelson is a health writer based in Florida who also writes about health and wellness for AARP, PBS’ Next Avenue, Shondaland, and others.