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High blood pressure doubles risk of severe COVID

Despite full vaccination, high blood pressure can more than double the risk of hospitalization from the Omicron-variant of COVID-19 infection. This includes a booster dose of the COVID-19 vaccine, according to a new report from the American Heart Association.

The study was focused on adults hospitalized with COVID-19 in Los Angeles between December 2021 and April 2022. In cases of severe COVID-19 illness, the impact of high blood pressure, also known as hypertension, remained even in the absence of other chronic diseases. 

“These findings are important since about half of the adults in the U.S. have high blood pressure,” said study lead author Dr. Joseph E. Ebinger.

COVID-19 vaccines helped reduce death and some of the most severe side effects from the infection early in the pandemic. A COVID-19 vaccine booster can further reduce the risks of severe illness by up to 70 percent.  

Despite these benefits, a portion of fully vaccinated and boosted people still required hospitalization during an early surge of the Omicron variant.

According to the U.S. Centers for Disease Control and Prevention, the Omicron variant continues to dominante, with seven sub variants identified. 

Ebinger and colleagues sought to understand the characteristics associated with the people who were hospitalized despite having the full COVID-19 vaccine series and a booster dose.

“Our data found that it is not just older adults with other underlying health conditions who are vulnerable,” Ebinger said. 

“Breakthrough Omicron infection severe enough to cause hospitalization can happen to an adult of any age, especially if a person has high blood pressure, even if they have no other major chronic disease. The people who are most at risk are not necessarily who we think they are. They are not the sickest of the sick, and this was a surprising finding.”

The study included 912 adults with at least three doses of an mRNA vaccine (either the Pfizer-BioNTech or Moderna COVID-19 vaccines) and were treated for infection during an Omicron surge.

Demographic information, including age, gender, race, ethnicity and health records were also examined. Variables such as chronic health conditions were considered, including diabetes, kidney disease, heart attack, heart failure and prior chronic pulmonary obstructive disease or asthma.

The analysis found:

  • Of the 912 adults who received three doses of an mRNA COVID-19 vaccine, nearly 16 percent required hospitalization.
  • Older age, high blood pressure, chronic kidney disease, heart attack, heart failure and the time between the last vaccination and COVID-19 infection were all associated with greater risks of hospitalization.
  • Individuals with high blood pressure were 2.6 times more likely to require hospital care for severe COVID-19 illness
  • Of the 145 patients hospitalized, 125 of them (86.2 percent) had high blood pressure. 

Receiving three doses of a vaccine may not prevent infection in everyone, especially those with high blood pressure. More research is needed to understand the link between high blood pressure and increased risk of COVID-19 illness, 

While knowledge of COVID-19 has come a long way, more research is needed to reduce the risk of serious COVID infection. This could include more tailored vaccine regimens, new therapeutics or a combination approach. 

The study was partially funded by Cedars-Sinai Medical Center, the Erika J. Glazer Family Foundation and the National Institutes of Health. The research is published in the journal Hypertension.

By Katherine Bucko, Staff Writer

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