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The impact of the COVID-19 Pandemic on hypertension phenotypes (ESH ABPM COVID-19 study)
Aleksandra Ostrowska1, Wiktoria Wojciechowska1, Marek Rajzer1
11st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland.
Insights
The COVID-19 pandemic negatively impacted blood pressure control. Hypertension phenotypes worsened during the pandemic, unlike in the pre-pandemic period, indicating a significant public health concern.
Area of Science:
- Cardiology
- Public Health
- Hypertension Research
Background:
- The COVID-19 pandemic significantly disrupted healthcare delivery globally.
- Effective blood pressure (BP) management is crucial for cardiovascular health.
- Understanding pandemic-related impacts on chronic disease management is essential.
Purpose of the Study:
- To evaluate the influence of the COVID-19 pandemic on blood pressure control.
- To assess changes in hypertension phenotypes during the pandemic using ambulatory BP monitoring (ABPM).
- To compare BP control in patients during and before the pandemic.
Main Methods:
- A comparative study involving 1419 patients with treated hypertension across 33 centers.
- Two groups were analyzed: a pandemic group (ABPM during COVID-19) and a pre-pandemic group (ABPM before COVID-19).
- Hypertension phenotypes including masked hypertension, white coat hypertension, sustained controlled hypertension (SCH), and sustained uncontrolled hypertension (SUCH) were assessed.
Main Results:
- No significant difference in baseline hypertension phenotypes between the groups.
- In the pandemic group, no significant change in hypertension phenotypes was observed between visits (p = 0.08).
- In contrast, the pre-pandemic group showed an increase in SCH (28.8% to 38.4%) and a decrease in SUCH (34.2% to 27.8%).
- Multivariable analysis identified the COVID-19 pandemic period as the sole factor linked to negative changes in hypertension phenotypes.
Conclusions:
- The COVID-19 pandemic period was associated with a negative impact on blood pressure control.
- Hypertension phenotypes showed detrimental changes during the pandemic compared to pre-pandemic trends.
- These findings highlight the need for continued monitoring and management of hypertension during public health crises.
Objective:
The COVID-19 pandemic had a major impact on medical care. This study evaluated the influence of the pandemic on blood pressure (BP) control and hypertension phenotypes as assessed by office and 24-hour ambulatory BP monitoring (ABPM).
Design And Methods:
Data were collected from 33 centers including Excellence Centers of the European Society of Hypertension. Two groups of patients with treated hypertension were compared. Pandemic group: including participants who had ABPM twice - at visit 2 during the COVID-19 pandemic and visit 1 performed 9-15 months prior to visit 2. Pre-pandemic group: had ABPM at two visits, performed before the pandemic within 9-15 months interval. We determined the following hypertension phenotypes: masked hypertension, white coat hypertension, sustained controlled hypertension (SCH) and sustained uncontrolled hypertension (SUCH). We analyzed the prevalence of phenotypes and their changes between visits.
Results:
Data of 1419 patients, 616 (43 %) in the pandemic group and 803 (57 %) in the pre-pandemic group, were analyzed. At baseline (visit 1), the prevalence of hypertension phenotypes did not differ between groups. In the pandemic group, the change in hypertension phenotypes between two visits was not significant (p = 0.08). In contrast, in the pre-pandemic group, the prevalence of SCH increased during follow-up (28.8 % vs 38.4 %, p < 0.01) while the prevalence of SUCH decreased (34.2 % vs 27.8 %, p < 0.01). In multivariable adjusted analysis, the only factor influencing negative changes of hypertension phenotypes was the COVID-19 pandemic period.
Conclusion:
These results indicate a negative impact of the COVID-19 pandemic on BP control assessed by hypertension phenotypes.
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