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Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension
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Impact of COVID-19 Infection on Blood Pressure Variability and Cardiovascular Outcomes in Hypertensive Patients After

Quanbin Su1, Mingming Wang1, Jing Yu1

  • 1Department of Cardiology, Lanzhou University Second Hospital, Lanzhou, China.

Journal of Clinical Hypertension (Greenwich, Conn.)
|November 26, 2025
PubMed

Insights

COVID-19 infection significantly impacts blood pressure variability (BPV) in hypertensive patients, leading to abnormal hemodynamic patterns and increased cardiovascular risk. Personalized hypertension management is crucial post-infection.

Area of Science:

  • Cardiovascular Medicine
  • Infectious Diseases
  • Hypertension Research

Background:

  • Hypertension management is critical for cardiovascular health.
  • COVID-19's long-term effects on cardiovascular parameters require further investigation.
  • Blood pressure variability (BPV) is an emerging risk factor for cardiovascular events.

Purpose of the Study:

  • To evaluate the impact of COVID-19 infection on blood pressure variability (BPV) and cardiovascular outcomes in hypertensive patients.
  • To identify hemodynamic patterns associated with poor prognosis after COVID-19 infection.
  • To elucidate the mechanisms linking COVID-19 infection to altered BPV and cardiovascular risk.

Main Methods:

  • Retrospective cohort study of 318 hypertensive patients over 2 years.
  • Utilized 24-hour ambulatory blood pressure monitoring (ABPM).
  • Employed structural equation modeling (SEM) and Cox regression analysis.

Main Results:

  • COVID-19 patients with poor prognosis exhibited elevated nocturnal systolic blood pressure (SBP) load, higher arterial relative volume (ARVDBP), wider pulse pressure, and reduced time in target BP range.
  • Infection status, nocturnal BP load, and BPV were identified as major risk factors for adverse outcomes.
  • SEM indicated that COVID-19 infection indirectly worsened prognosis via increased nighttime BP levels, load, and variability.

Conclusions:

  • COVID-19 infection exacerbates BPV and cardiovascular risk in hypertensive individuals, primarily through mechanisms like endothelial dysfunction and autonomic dysregulation.
  • Individualized hypertension management strategies are essential during and after infection.
  • Recommendations include optimizing renin-angiotensin system blockade, considering nighttime dosing of antihypertensives, and continuous circadian BP monitoring.

Keywords:
COVID‐19ambulatory blood pressure monitoringblood pressure variabilitycardiovascular outcomeshypertension

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