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1 - Carotid Massage 2- Valsalva Maneuver 3- Breathing Technique 4 - Dive Reflex
MALAYSIA recorded 6,976 new Covid-19 cases on May 23, the highest number of daily cases reported since the start of the pandemic in March 2020. The number of Covid-19 deaths and severe cases that require intensive care has also increased tremendously.
According to Health Ministry statistics, from May 1 to 21, Malaysia lost 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 ICUs increased by 91% (from 337 to 643) and patients requiring ventilation support doubled from 176 to 363.
Covid-19 has negatively impacted the care of patients with noncommunicable diseases such as hypertension and diabetes. Hypertension (high blood pressure) is the most common pre-existing medical condition among Covid-19 patients globally as well as in Malaysia. Patients with hypertension are 95% more likely to require ICU admission and 160% more likely to succumb to the disease. A local study reported that 49% of patients with the severe form of Covid-19 had hypertension, compared with 13% among mild cases. The high prevalence of hypertension in Malaysia – three in every 10 adults have it – means that a substantial proportion of our adult population is at risk.
Adherence to and compliance with medication is crucial. Stop-ping 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 outcomes.
In addition, once the virus enters the body, it could lead to overactivation of the immune system resulting in a cytokine storm, further burdening a cardiovascular and respiratory system that is already in a suboptimal state. This probably explains why hypertension is the most common comorbidity among Covid-19 patients, especially among those who experience the severe version of the disease.
Maintaining a healthy blood pressure (below 140/90mmHg for systolic and diastolic respectively) is important. Take these steps to control your blood pressure:
> Know your blood pressure levels. Monitor them regularly. This is important to see whether efforts to control the pressure are sufficient or should be improved.
> Limit salt intake in your diet according to daily recommendations. This can be achieved by carefully inspecting food labels for salt and sodium content, avoiding preserved and processed foods, and replacing salt with herbs and spices in cooking.
> Keep your body weight within the normal range. For overweight people, weight loss of 3% to 9% from current body weight has been shown to reduce blood pressure readings by 3mmHg to 6mmHg.
> Exercise consistently. Regular aerobic exercise, such as brisk walking and jogging, for at least 150 minutes a week is recommended as it is beneficial for the cardiovascular system and can help lower blood pressure.
> Quit smoking and avoid alcohol intake as both activities have been shown to increase blood pressure.
> Keep taking your current medications and continue to go for 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 all this, hypertensive patients must seriously follow the current Covid-19 SOP and make every effort to protect yourselves from contracting the disease.
DR NOR AFIQAH NORDIN, DR ANG SWEE HUNG, PROF DR MOY FOONG MING & PROF DR NORAN NAQIAH HAIRI
Public Health Department, Universiti Malaya Medical Centre (UMMC)
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