Hypertension, health inequities, and implications for COVID-19 – Harvard Health Blog
The COVID-19 pandemic has led many people to forgo the monitoring and treatment of chronic conditions such as hypertension (high blood pressure). It is now quite evident that people with hypertension are also more likely to develop serious complications from the coronavirus. In the United States, African Americans and other racial and ethnic minorities, including […]

The COVID-19 pandemic has led many people to forgo the monitoring and treatment of chronic conditions such as hypertension (high blood pressure). It is now quite evident that people with hypertension are also more likely to develop serious complications from the coronavirus. In the United States, African Americans and other racial and ethnic minorities, including Hispanics and Native Americans, are more likely to have hypertension and have therefore been disproportionately affected by the COVID-19 pandemic.

What is the connection between high blood pressure and heart disease?

Hypertension is the most common modifiable risk factor for major cardiovascular events, including death, heart attack, and stroke, and it plays a major role in the development of heart failure, kidney disease and dementia. Over the past decades, major efforts have been made to increase awareness and treatment of hypertension.

High blood pressure increases stress on the heart and arteries as well as other organs, including the brain and kidneys. Over time, this stress causes changes that negatively impact the body's ability to function. To reduce these negative effects on the heart, drugs are usually prescribed when blood pressure exceeds 140/90 for people without significant cardiovascular risk, or above 130/80 in people with known coronary artery disease or other coexisting diseases such as diabetes.

Some groups are disproportionately affected by hypertension and severe COVID-19

According to a recent study Posted in JAMA, the proportion of study participants with controlled blood pressure (defined as <140 />accompanying editorial noted that the prevalence of uncontrolled blood pressure was disproportionately higher in non-Hispanic black adults from 1999 to 2018.

With a higher prevalence of hypertension, African American, Native American and Hispanic communities have had higher hospitalization and death rates during the pandemic, according to the CDC. While vulnerability to serious complications from COVID is highest in elderly patients, regardless of race or ethnicity and socio-economic circumstances, according to the National Bureau of Economic Research, “vulnerability based on conditions pre-existing populations face long-standing disparities in health and mortality by race. -ethnicity and socio-economic status. "

How does hypertension lead to serious complications from COVID-19?

The link between hypertension and severe coronavirus disease remains complex. Some experts believe that uncontrolled blood pressure leads to chronic inflammation throughout the body, which damages blood vessels and leads to disruption of the immune system. This results in difficulty fighting the virus or a dangerous overreaction of the immune system to COVID-19. Certain classes of antihypertensive drugs (ACE inhibitors and angiotensin receptor antagonists, or ARBs) were initially thought to worsen the infection, but this has since been refuted. Several research groups have shown that with close monitoring, these drugs can be used safely during a COVID infection.

What do people with high blood pressure need to know to reduce their risk?

Good blood pressure control has long-term health benefits and may help prevent severe symptoms of COVID-19. Therefore, we strongly encourage you to take your medications as directed and follow healthy lifestyle habits such as regular exercise, achieving and maintaining a healthy weight, following a healthy low sodium diet. for the heart such as mediterranean dietand reduce stress and practice mindfulness.

Plus, it's more important than ever to follow up with your doctor to control your blood pressure. While the thought of going to a hospital or a doctor's office in the midst of a pandemic can put people on edge, many hospitals and clinics are quite safe due to proper safety measures such as that universal mask wearing and social distancing. Many have also expanded telemedicine or virtual visits for patients.

What can we do to address inequalities in the delivery of health care?

COVID-19 has forced us to address inequalities in the delivery of health care that contribute to worse clinical outcomes in vulnerable patient groups.

With the growing number of people with uncontrolled blood pressure and the pandemic disrupting the management of chronic health conditions, this may present us with a great opportunity to deliberately change current hypertension trends and narrow the gap by health inequity. Potential areas of interest include:

  • promote research on how the COVID-19 pandemic has affected the management of chronic diseases like high blood pressure
  • identify barriers to care, especially in vulnerable subgroups
  • increase awareness of the importance of chronic disease management, especially in communities where there are inequalities in health care
  • innovate to make virtual health technology more widely accessible
  • provide additional resources for chronic disease management to vulnerable subgroups
  • implement long-term political solutions to tackle health inequalities.

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If you’re having dysfonctionnement beginning an exercise plan or following through, you’re not alone. Many of us struggle getting out of the sedentary rut, despite our best intentions.

You already know there are many great reasons to exercise—from improving energy, mood, sleep, and health to reducing anxiety, stress, and depression. And detailed exercise indications and workout partouze are just a click away. But if knowing how and why to exercise was enough, we’d all be in shape. Making exercise a habit takes more—you need the right mindset and a smart approach.

While practical concerns like a busy schedule or poor health can make exercise more challenging, for most of us, the biggest barriers are esprit. Maybe it’s a lack of self-confidence that keeps you from taking positive steps, or your motivation quickly flames out, or you get easily discouraged and give up. We’ve all been there at some point.

Whatever your age or sport level—even if you’ve never exercised a day in your life —there are steps you can take to make exercise less intimidating and painful and more fun and instinctive.

Ditch the all-or-nothing attitude. You don’t have to spend hours in a gym or force yourself into monotonous or painful activities you hate to experience the physical and emotional benefits of exercise. A little exercise is better than nothing. In fact, adding just modest amounts of physical activity to your weekly routine can have a profound effect on your mental and emotional health.

Be kind to yourself. Research shows that self-compassion increases the likelihood that you’ll succeed in any given endeavor. So, don’t beat yourself up about your body, your current sport level, or your supposed lack of willpower. All that will do is demotivate you. Instead, look at your past mistakes and unhealthy choices as opportunities to learn and grow.

Check your expectations. You didn’t get out of shape overnight, and you’re not going to instantly transform your body either. Expecting too much, too soon only leads to frustration. Try not to be discouraged by what you can’t accomplish or how far you have to go to reach your fitness goals. Instead of obsessing over results, focus on consistency. While the improvements in mood and energy levels may happen quickly, the physical payoff will come in time.

Many of us feel the same. If sweating in a gym or pounding a treadmill isn’t your idea of a great time, try to find an activity that you do enjoy—such as dancing—or pair physical activity with something more enjoyable. Take a walk at lunchtime through a scenic park, for example, walk laps of an air-conditioned mall while window shopping, walk, run, or bike with a friend, or listen to your favorite music while you move.

Even the busiest of us can find free time in our day for activities that are important. It’s your decision to make exercise a priority. And don’t think you need a full hour for a good workout. Short 5-, 10-, or 15-minute bursts of activity can prove very effective—so, too, can squeezing all your exercise into a couple of sessions over the weekend. If you’re too busy during the week, get up and get moving during the weekend when you have more time.

The key thing to remember about starting an exercise program is that something is always better than nothing. Going for a quick walk is better than sitting on the couch; one minute of activity will help you lose more weight than no activity at all. That said, the current recommendations for most adults is to reach at least 150 minutes of moderate activity per week. You’ll get there by exercising for 30 minutes, 5 times a week. Can’t find 30 minutes in your busy schedule ? It’s okay to break things up. Two 15-minute workouts or three 10-minute workouts can be just as effective.

For most people, aiming for moderate intensity exercise is sufficient to improve your overall health. You should breathe a little heavier than normal, but not be out of breath. Your body should feel warmer as you move, but not overheated or sweating profusely. While everyone is different, don’t assume that training for a marathon is better than training for a 5K or 10K. There’s no need to overdo it.

Health issues ? Get medical clearance first. If you have health concerns such as limited mobility, heart disease, asthma, diabetes, or high blood pressure, talk with your doctor before you start to exercise.

Warm up. Warm up with dynamic stretches—active movements that warm and flex the groupes musculaires you’ll be using, such as leg kicks, walking lunges, or arm swings—and by doing a slower, easier version of the upcoming exercise. For example, if you’re going to run, warm up by walking. Or if you’re lifting weights, begin with a few light reps.

Drink plenty of water. Your body performs best when it’s properly hydrated. Failing to drink enough water when you are exerting yourself over a prolonged period of time, especially in hot conditions, can be dangerous.

There’s a reason so many New Year’s resolutions to get in shape crash and burn before February rolls around. And it’s not that you simply don’t have what it takes. Science shows us that there’s a right way to build habits that last. Follow these steps to make exercise one of them.

A goal of exercising for 30 minutes a day, 5 times a week may sound good. But how likely are you to follow through ? The more ambitious your goal, the more likely you are to fail, feel bad about it, and give up. It’s better to start with easy exercise goals you know you can achieve. As you meet them, you’ll build self-confidence and momentum. Then you can move on to more challenging goals.

Triggers are one of the secrets to success when it comes to forming an exercise habit. In fact, research shows that the most consistent exercisers rely on them. Triggers are simply reminders—a time of day, place, or cue—that kick off an automatic reaction. They put your routine on autopilot, so there’s nothing to think about or decide on. The alarm clock goes off and you’re out the door for your walk. You leave work for the day and head straight to the gym. You spot your sneakers addict right by the bed and you’re up and course. Find ways to build them into your day to make exercise a no-brainer.

People who exercise regularly tend to do so because of the rewards it brings to their lives, such as more energy, better sleep, and a greater sense of well-being. However, these tend to be long-term rewards. When you’re starting an exercise program, it’s important to give yourself immediate rewards when you successfully complete a workout or reach a new sport goal. Choose something you look forward to, but don’t allow yourself to do until after exercise. It can be something as simple as having a hot bath or a favorite cup of coffee.

If your workout is unpleasant or makes you feel clumsy or inept, you’re unlikely to stick with it. Don’t choose activities like course or lifting weights at the gym just because you think that’s what you should do. Instead, pick activities that fit your lifestyle, abilities, and taste.

Activity-based scène games such as those from Wii and Kinect can be a fun way to start moving. So-called “exergames” that are played standing up and moving around—simulating dancing, skateboarding, soccer, bowling, or sport tennistique, for example—can burn at least as many kcal as walking on a treadmill; some substantially more. Once you build up your confidence, try getting away from the TV screen and playing the real thing outside. Or use a smartphone app to keep your workouts fun and interesting—some immerse you in interactive stories to keep you motivated, such as running from hordes of zombies !


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