not shaping up to be an exception according to a study done in India, which found a death rate of nearly 50 percent for patients that had high blood pressure, diabetes, and heart disease.
Metabolic syndrome is seen as a disease largely caused by lifestyle, particularly eating too much and exercising too little. The good news is that you can take steps to reduce the severity of metabolic syndrome in your life, thereby reducing the risk due to exposure to the virus.
It is also important to remember that most of the conditions included in metabolic syndrome will weaken your immune system, so boosting your immune system is critically important to put you in the best position to fight back against COVID-19.
Now let’s take a closer look at the risk factors that are more likely to make COVID-19 worse and also what steps to take to reduce these risks.
Risk Factors for COVID-19
• being age sixty-five and over
• high blood pressure
• obesity
• diabetes
• chronic lung diseases (chronic obstructive pulmonary disease [COPD] and asthma)
• cardiovascular disease, including heart disease and atrial fibrillation
• kidney disease
• immunosuppression
• cancer and being a cancer survivor
Age Sixty-Five and Over
Since the coronavirus was first identified, one fact has stood out consistently: those people who become most seriously ill have been age sixty-five and older. If you’re in this age group, protecting against COVID-19 becomes extra important. If you’re age eighty-five and older, you have the highest risk of dying of the disease.
Recommendations:
• Follow the recommendations on wearing a mask and social distancing outlined elsewhere in this book.
• If you work, ask your employer whether you can work from home.
• During the pandemic, restaurants were closed. When you go to them after they’ve reopened, give yourself some distance in seating and steer clear of any buffets to minimize the possibility of contamination.
• Make use of the special “Senior Hours” at supermarkets and other stores, both for those age sixty-five and older and for those at risk with other health conditions outlined here.
• At times when the virus is spreading, steer clear of crowds, including those at “senior” events, especially if people are not wearing masks or taking precautions.
• If meals are an issue, ask your municipality if you qualify for “Meals on Wheels.”
• Avoid mass transit; if you don’t drive, ask your local municipality or senior center about vans or smaller buses and make sure drivers are taking precautions.
High Blood Pressure
In every country hit by the virus, one thing also stands out—having high blood pressure, or hypertension, also puts you at the highest risk for being hospitalized or dying if you get COVID-19.
But why is this so? One possible explanation is that having high blood pressure weakens the heart and makes people with it more vulnerable to pulmonary problems.
But there is another possible reason, and this has to do with how high blood pressure is treated. There is a controversy surrounding the common high blood pressure drugs called ACE inhibitors and angiotensin receptor blockers (ARBs).
Here’s the issue: When the coronavirus enters the body, it finds cells lined with ACE2 receptors to replicate and destroy. ACE inhibitors and ARBs, which are high blood pressure medications, can upgrade the number of ACE2 receptor sites, giving the virus more points in the body to attack and potentially making the disease outcome and course more severe and lethal.
Several medical associations, including the American College of Cardiology and the American Heart Association, contend that these concerns are unproven and people should continue to take these drugs as prescribed. There is also a contention that these drugs may actually help treat COVID-19 by providing decoy cells for the virus to attack.
But as there are other drugs that can lower blood pressure, most notably calcium channel blockers and beta-blockers, it seems to make sense to ask your doctor if one of these drugs would work just as well for you. Of course, never discontinue taking prescription drugs or change them without your doctor’s approval.
Recommendations:
• Make sure you have a thirty-day supply of your medication.
• Keep your blood pressure under control.
• Be careful of certain medications, like NSAIDs, and certain decongestants, which can raise blood pressure, as can some drugs that treat mental health conditions, corticosteroids, oral birth control, medications that suppress the immune system, some cancer medications, over-the-counter drugs, and supplements.
• Limit your intake of caffeine, certain teas, and energy drinks that have stimulants that can raise blood pressure. The candy licorice can do this as well.
• Buy a home blood pressure monitor and use it to keep an eye on your blood pressure.
• Ask about using telemedicine for follow-up visits.
Diabetes
Researchers in China found that people with diabetes had three times the death rates as those without diabetes, and studies in other countries have found this as well. People with diabetes have also been found to be at greater risk if they take ACE inhibitors or ARBs, and the possible reason can be found above in this chapter, so talk to your doctor if you take these medications. Also, people with type 2 diabetes (the most common form) may have an altered immune response, and those with type 1 diabetes have a tendency to develop a condition known as diabetic ketoacidosis. Diabetic ketoacidosis can result in severe dehydration, worsening other serious complications of COVID-19.
Recommendations:
• Make sure you have a thirty-day supply of your medication.
• Maintain tight blood sugar control to help reduce the risk of infections and complications.
• Keep a ninety-day supply of diabetes supplies, medications, and insulin (if you use it) on hand.
• Consider using telemedicine for follow-up doctor’s visits.
Obesity
