Hypoxemia (Low Blood Oxygen): Causes, Symptoms And Treatment

COVID-19 May Trigger New-onset High Blood Pressure In High Risk Individuals

Researchers are reporting that people who have had COVID-19 were more likely to experience a new onset of high blood pressure.

The risk was higher for people with preexisting conditions, along with older adults, men, and Black Americans.

Understanding the long-term effects of COVID-19 remains a work in progress, and deciphering individual symptoms can be a tricky process.

New research suggests that people who have had COVID-19 are more likely to develop hypertension, even with no prior history of high blood pressure.

The findings were published today in Hypertension, a journal of the American Heart Association.

In an analysis of six-month follow-up data from more than 45,000 people who had COVID-19, researchers reported that 21% of people who were hospitalized for the virus and 11% who were not hospitalized later developed high blood pressure.

While similar effects happen with influenza – a similar respiratory infection – the numbers were higher across the board for people who've had COVID-19, the researchers reported.

Tim Q. Duong, a senior study author and a professor of radiology and vice chair for radiology research and associate director of Integrative Imaging and Data Science at the Center for Health and Data Innovation at Albert Einstein College of Medicine and Montefiore Health System in New York City, told Medical News Today that the findings could be a sign of what's to come for the millions of people worldwide who've had COVID-19.

"Infection may trigger new-onset hypertension or exacerbate preexisting hypertension long after acute infection has resolved," he explained. "It is important to determine whether SARS-CoV-2 infection increases incidence of new-onset persistent hypertension in patients who had COVID-19, as it could constitute a major long-term population health issue."

The data analyzed in the study comes from the New York metropolitan area, specifically the Bronx – an area with significant lower socioeconomic status.

Duong explained that higher-risk groups include older adults, men, and Black Americans. While increased risk among older adults was expected, the findings provide important new data when it comes to understanding how so-called "long COVID" affects the body.

"This is the first study to show that male COVID patients are more susceptible to developing new hypertension as part of long COVID," Duong said. "It's also the first study to show that African-Americans with COVID-19 are more susceptible to developing new hypertension. The reasons that these groups or populations have increased risks are multifactorial."

Caveats to the data include the fact that participant data was limited to people who had interacted with the healthcare system. This means that the many people who had COVID-19 without seeing a doctor were not represented, so the findings skew toward those who had more severe cases.

While the findings indicate that COVID-19 is associated with the development of high blood pressure that wasn't there before, there are also a host of preexisting conditions that made the risk higher.

Those in the study who had conditions such as chronic obstructive pulmonary disease, coronary artery disease, or chronic kidney disease, were more likely than others to develop high blood pressure.

Emily E. Volk, the president of the College of American Pathologists, vice president of Pathology and Clinical Laboratories for the University of Louisville Health System in Kentucky, and an associate professor of pathology at the University of Louisville School of Medicine, said that blood clotting abnormalities have been observed in many people with COVID-19, which in turn carries an increased risk of heart attack and stroke.

"With any organ in the body that doesn't get the appropriate amount of blood flow, the arterial capillaries feeding it will die and then create more, which leads to a cycle of more inflammation," Volk, who was not involved in the study, told Medical News Today. "It really can create quite a cycle of destruction. It's interesting to me that high blood pressure – which is fundamentally an abnormality in the vasculature – would be associated with some patients with long COVID. There may very well be a link there."

One of the major challenges associated with the pandemic, right from the start, has been a lack of information.

As a new virus, health professionals have been playing catch-up from the start and understanding the long-term effects of COVID-19 remains a work in progress.

Still, in the more than three years since the virus was first identified, experts say significant breakthroughs have been made.

"It's been remarkable exponential growth in our understanding, and frankly, the fact that the scientific community was able to isolate the virus and then create vaccines for the virus so quickly and so effectively, is remarkable," said Volk. "It really is a testament to where we have advanced in our understanding of molecular biology, neurology, and immunology."

Symptoms of COVID-19, and long COVID, are all over the map, but some commonalities have been identified. Volk said that there are many non-specific symptoms that are hard to localize and one major complaint has been headaches or "brain fog."

"For some patients, this can really interfere with their ability to function out in the world," she explained. "I think fatigue is one thing, but when you are finding it difficult to do your daily activities, your daily living, because you're not able to think clearly or do your job that you were previously competent at, I think that's very frightening to patients."

Because these symptoms are tough to pin down and treat, Volk recommends that people exercise persistence and patience with their doctors.

"It's really a diagnosis of exclusion because the symptoms are often non-specific," she said. "Job one of that patient's physician is going to be sorting out whether there are other possible causes for the symptoms, because you can't assume from the start that it's all due to COVID-19. That's the hard work that the physician has to sort through with the patient."

She added that it's also important, as always, to get vaccinated and or boosted for respiratory infections such as influenza and COVID-19, especially with colder weather and flu season right around the corner.

"If there's anybody out there who hasn't gotten the COVID-19 vaccine, it might be a good time to reconsider," said Volk. "Kids are going back to school and we're all going to be heading back inside for the fall and winter. If you haven't done it yet, it's OK. Anybody who can get vaccinated, we would be happy to vaccinate."

What To Know About Pulmonary Arterial Hypertension

Aug. 13—(StatePoint) Each year, an estimated 500-1,000 people nationwide are diagnosed with pulmonary arterial hypertension (PAH). While there's currently no cure, treatment can help control symptoms and improve quality of life.

The American Lung Association, with support from Janssen, launched a new campaign to ensure patients get an earlier, accurate PAH diagnosis and feel empowered to participate in discussions regarding treatment options. As part of the campaign, they're also sharing insights from Lindsay T., a patient living with PAH.

—PAH defined: PAH is a progressive disorder and one form of a broader condition known as pulmonary hypertension, which is high blood pressure in the lungs. In PAH, this increased pressure in the vessels is caused by obstruction in the small arteries in the lung, and can occur for a variety of reasons.

—Causes: While the cause of PAH is usually unknown, about 15-20% of patients have inherited the condition. Most common in women ages 30-60, PAH disproportionately impacts African American and Hispanic women.

—Symptoms: Individuals are initially asymptomatic and then begin to experience symptoms similar to other common lung diseases, such as shortness of breath and fatigue. For this reason, PAH can be difficult to diagnose — 74% of patients are diagnosed in advanced stages of the disease. Eventually, symptoms can include swelling of the feet, legs, abdomen and neck, dizziness and fainting spells, chest pain, heart palpitations, and lips and fingers turning blue.

"When I was 23, I started noticing that when I would walk, I would get out of breath really easily. At first, I thought I was just out of shape. It took about a year for my doctors to say it was pulmonary arterial hypertension," says Lindsay.

—Diagnosis: To confirm diagnosis, a right heart catheterization is needed to measure pressure in the heart and lungs. Providers will typically rule out other common diseases with less invasive tests first. An accurate diagnosis of the correct type of pulmonary hypertension helps ensure prompt, optimal treatment. When PAH is suspected, patients should be referred to a PAH specialist at an accredited center. Left untreated, PAH compromises heart function, which can lead to heart failure and even death.

—Treatment: Patients should see their specialist regularly for structured evaluations. This allows for tailored treatment plans.

Treatment may include supportive therapies, such as supplemental oxygen, pulmonary rehabilitation and diuretic medications, as well as specific treatment, including medications that dilate blood vessels and affect the vasculature to reduce the increased resistance of blood flow that contributes to right-sided heart failure.

There are many clinical trials occurring right now. Those interested should speak with their healthcare provider or visit Clinicaltrails.Gov.

—Tracking: Tracking symptoms is a vital part of self-management of the condition.

"One of the most important things to do while living with PAH is to learn to listen to your body because it'll tell you if you need something, and that's information that you can talk about with your healthcare team," says Lindsay, who after noticing worsening symptoms, spoke to her specialist who then started her on a new medication.

Lindsay also advises patients to become their own advocates. "Research empowered me to take control of my diagnosis and actually make decisions for my healthcare," she says.

—Support: Support groups give patients a chance to connect with others living with their condition. Patients can also learn more at Lung.Org/PAH.

While PAH is a serious, potentially life-threatening condition, proper treatment can make the disease manageable. After finding the right treatment plan, Lindsay is thriving.

"This life I lead today, I'm physically active. I teach high school algebra. I'm successfully managing my PAH. It's not easy, but it's possible," says Lindsay.

Photo Credit: (c) American Lung Association

How To Know If You Have Pulmonary Hypertension? Here Are Some Signs

What is pulmonary hypertension?

Pulmonary artery hypertension is a condition in which there is elevated blood pressure in the blood vessels carrying blood to the lungs. This blood vessel is known as Pulmonary artery; hence the name of the disease is pulmonary artery hypertension. In general, this means that a person has high blood pressure in pulmonary arteries. Due to resistance because of the high blood pressure in the pulmonary artery, the heart works harder to push the blood across to the lungs.

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As a result, heart muscles become thicker and weaker, and due to this at times heart failure can occur.

Here's what the expert says Dr. Tushar Tayal, Consultant, Internal Medicine, CK Birla Hospital, Gurugram says, "There are multiple causes that a person can develop pulmonary hypertension. However, it usually happens when there is a problem with heart or lung disease but there could be other factors also that a person develops PAH such as coronary artery disease, cirrhosis, blots clots to the lungs and even genetics play a critical role in aggravating the disease. It is observed that PAH can happen at any age, but it tends to grow with the increasing age. It is important to have proper treatment, otherwise it can cause ripple effects on the body and can lead problems to other working organs of the human body."

Symptoms of pulmonary hypertension Well, the common symptom observed in patients dealing with PAH is the shortness of breath while doing normal activities or even when the body is at rest. There are other symptoms which include* Bluish or Grayish colour of skin* Chest pain* fainting spells.* Rapid heart rate* Swelling in feet* Dizziness* Fatigue.* Feeling less hungry than usual.* Pain in the upper right side of the stomachPAH can also cause complications such as* Low haemoglobin* irregular heart rate* Blood clots in your pulmonary arteries.* Pericardial effusion.

Causes of pulmonary hypertension "There are multiple causes of pulmonary artery hypertension which may be genetic, autoimmune, secondary to underlying lung disease, infectious disease or drug abuse," says Tayal.Some common causes are -* Congenital heart disease* HIV.* Liver disease and portal hypertension* Lupus* Scleroderma.* Recreational drugs like methamphetamine.* COPD* OBSTRUCTIVE SLEEP APNOEA* Aortic and mitral valve disease* Sarcoidosis* kidney disease* Thyroid disease* Tumors

The takeaway "Diagnosis of pulmonary artery hypertension can be done on the basis of history and clinically and ascertained with the help of certain tests such as ECG or EKG, Echocardiogram, 2 D echo, Chest X ray , CT Scan Chest etc. However, depending on the condition of the lungs and pulmonary arteries there are other tests also done such as Exercise stress test, MRI, lung function test, sleep study, lung biopsy, Ventilation/perfusion (V/Q) scan to check the possible cause of pulmonary hypertension and basis on the same treatment undergoes," advises Dr. Tayal.

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