By IDSE News Staff
SARS-CoV-2 infection is significantly associated with the development of hypertension in adults with preexisting heart conditions or those who were older, Black or male (Hypertension 2023 Aug 21. https://doi.org/10.1161/HYPERTENSIONAHA.123.21174)
This retrospective, observational study is the first to investigate the development and risk factors associated with persistent high blood pressure in people with COVID-19 infection compared with influenza, a similar respiratory virus. According to the 2017 ACC/AHA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults, hypertension is classified as having top and bottom numbers greater than or equal to 130/80 mm Hg.
For the study, health data were analyzed from electronic health records at the Montefiore Health System in Bronx, N.Y., which serves a large, racially and ethnically diverse population. The study included 45,398 people with COVID-19 who were hospitalized between March 1, 2020, and Feb. 20, 2022, and 13,864 people with influenza without COVID-19, who were hospitalized between January 2018 and Feb. 20, 2022, who returned to the hospital system for any medical reasons within an average follow-up period of six months.
The analysis found:
- 21% of people hospitalized with COVID-19 and 11% of those who were not hospitalized for COVID-19 developed hypertension, compared with 16% of people hospitalized with influenza and 4% of those not hospitalized for influenza.
- People hospitalized for COVID-19 were more than twice as likely, and those not hospitalized were 1.5 times more likely to develop persistent hypertension as people hospitalized and not hospitalized with influenza, respectively.
- People infected with SARS-CoV-2 who were older than 40 years, men, Black adults or those with preexisting conditions, such as chronic obstructive pulmonary disease, coronary artery disease or chronic kidney disease, had an elevated risk for developing hypertension.
- Persistent high blood pressure was more common among people infected with SARS-CoV-2 who were treated with vasopressor and corticosteroid medications during the pandemic.
“Given the sheer number of people affected by COVID-19 compared to influenza, these statistics are alarming and suggest that many more patients will likely develop high blood pressure in the future, which may present a major public health burden,” said senior study author Tim Q. Duong, PhD, a professor of radiology and the vice chair for radiology research, and an 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.
“These findings should heighten awareness to screen at-risk patients for hypertension after COVID-19 illness to enable earlier identification and treatment for hypertension-related complications, such as cardiovascular and kidney disease,” he said.
The researchers noted that the people in the study were mainly from communities with low socioeconomic status, which may increase their susceptibility to developing hypertension after COVID-19 infection. Other factors may also have contributed to the development of high blood pressure in the study patients, including the effects of isolation, psychosocial stress, reduced physical activity, unhealthy diet and weight gain during the COVID-19 pandemic. Researchers also noted that longer follow-up studies will be needed to determine whether the effects of COVID-19?related complications on the heart and blood pressure regulation may resolve on their own, or if there may be long-lasting effects on patients’ cardiovascular systems.
The study’s limitations included that findings were restricted to people who interacted with the health system during the follow-up period and who might be more likely to have severe COVID-19; the possibility that some patients had undiagnosed high blood pressure; the possibility that vaccination status, which might affect severity of COVID-19 illness, may not have been captured in the healthcare system database if COVID-19 vaccines were administered outside of the system; and the potential for unintended patient selection bias in a retrospective analysis.
