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Vol 27, No 3 (2023)
Original paper
Published online: 2023-09-27
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Blood pressure control in tertiary-care hypertensive patients during COVID-19 pandemic

Jacek Wolf1, Anna Nieckarz1, Anna Panfil1, Aleksandra Białas1, Julia Sternicka1, Łukasz Jędrzejewski1, Michał Hoffmann1, Anna Szyndler1, Aleksander Prejbisz2, Michel Burnier13, Krzysztof Narkiewicz1
DOI: 10.5603/ah.97622
·
Arterial Hypertension 2023;27(3):145-151.
Affiliations
  1. Department of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland
  2. Department of Epidemiology, Prevention of Cardiovascular Diseases and Health Promotion, National Institute of Cardiology, Warsaw, Poland
  3. Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland

open access

Vol 27, No 3 (2023)
ORIGINAL PAPERS
Published online: 2023-09-27

Abstract

Background: Cardiovascular risk factors distribution during the pandemic suggests worsening of the cardiovascular risk profile of hypertensive patients. At the same time, data on quality of hypertension control during the COVID-19 pandemic are scarce, in Poland. The aim of the study was to analyse the quality of blood pressure (BP) control in a group of patients who required regular control in tertiary care.

Material and methods: The study included  patients regularly monitored in Gdańsk Hypertension Centre for at least 4 years with at least 2 visits a year prior the analysis. The size of the group was calculated based on the original data of first 50 consecutive records of patients (power of 90%). Records were retrospectively analysed with respect to office blood pressure (oBP) control. Additionally, within-visit BP variability was calculated (difference of maximum and minimum BP from 3 measurements); body weight, age, sex, duration of hypertension, number of visits per year, seasonal BP variability, use of telemedical services, comorbidities and BP-lowering treatment were recorded.

Results: The study enrolled 220 patients. The values of systolic BP (sBP) before and after the break in the whole group were 135.8 ± 17.1 mm Hg vs. 137.9 ±19.5 mm Hg; P=0.08, and a diastolic BP (dBP) of 80.3 ±11.4 mm Hg vs. 82.6 ±12.2 mm Hg; p = 0.001. After adjusting for seasonal variation of BP, the respective differences were: sBP: 134.8 ± 16.5 vs. 138.0 ± 19.4; p = 0.03, and dBP: 79.4 ±10.9 vs. 82.2 ± 11.9; p = 0.004. Before 2020, 61.4% of patients were controlled (BP < 140/90 mm Hg), whereas after the pandemic-driven break in regular visits the control rate decreased to 55.5% (p = 0.21).

Conclusions: BP increased significantly and the rate of BP control decreased during the COVID-19 pandemic in a group of patients requiring tertiary care for hypertension.

Abstract

Background: Cardiovascular risk factors distribution during the pandemic suggests worsening of the cardiovascular risk profile of hypertensive patients. At the same time, data on quality of hypertension control during the COVID-19 pandemic are scarce, in Poland. The aim of the study was to analyse the quality of blood pressure (BP) control in a group of patients who required regular control in tertiary care.

Material and methods: The study included  patients regularly monitored in Gdańsk Hypertension Centre for at least 4 years with at least 2 visits a year prior the analysis. The size of the group was calculated based on the original data of first 50 consecutive records of patients (power of 90%). Records were retrospectively analysed with respect to office blood pressure (oBP) control. Additionally, within-visit BP variability was calculated (difference of maximum and minimum BP from 3 measurements); body weight, age, sex, duration of hypertension, number of visits per year, seasonal BP variability, use of telemedical services, comorbidities and BP-lowering treatment were recorded.

Results: The study enrolled 220 patients. The values of systolic BP (sBP) before and after the break in the whole group were 135.8 ± 17.1 mm Hg vs. 137.9 ±19.5 mm Hg; P=0.08, and a diastolic BP (dBP) of 80.3 ±11.4 mm Hg vs. 82.6 ±12.2 mm Hg; p = 0.001. After adjusting for seasonal variation of BP, the respective differences were: sBP: 134.8 ± 16.5 vs. 138.0 ± 19.4; p = 0.03, and dBP: 79.4 ±10.9 vs. 82.2 ± 11.9; p = 0.004. Before 2020, 61.4% of patients were controlled (BP < 140/90 mm Hg), whereas after the pandemic-driven break in regular visits the control rate decreased to 55.5% (p = 0.21).

Conclusions: BP increased significantly and the rate of BP control decreased during the COVID-19 pandemic in a group of patients requiring tertiary care for hypertension.

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Keywords

office blood pressure; COVID-19 pandemic; telemedicine

About this article
Title

Blood pressure control in tertiary-care hypertensive patients during COVID-19 pandemic

Journal

Arterial Hypertension

Issue

Vol 27, No 3 (2023)

Article type

Original paper

Pages

145-151

Published online

2023-09-27

Page views

357

Article views/downloads

312

DOI

10.5603/ah.97622

Bibliographic record

Arterial Hypertension 2023;27(3):145-151.

Keywords

office blood pressure
COVID-19 pandemic
telemedicine

Authors

Jacek Wolf
Anna Nieckarz
Anna Panfil
Aleksandra Białas
Julia Sternicka
Łukasz Jędrzejewski
Michał Hoffmann
Anna Szyndler
Aleksander Prejbisz
Michel Burnier
Krzysztof Narkiewicz

References (31)
  1. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021; 398(10304): 957–980.
    CrossRefPubMed
  2. Muntner P, Miles MA, Jaeger BC, et al. Blood Pressure Control Among US Adults, 2009 to 2012 Through 2017 to 2020. Hypertension. 2022; 79(9): 1971–1980.
    CrossRefPubMed
  3. Zdrojewski T, Rutkowski M, Bandosz P, Gaciong Z, Solnica B, Drygas W. Ocena rozowszechnienia i kontroli czynników ryzyka chorób serca i naczyń w Polsce — badania NATPOL 1997, 2002, 2011. In: Kopeć G, Pająk A. ed. Epidemiol i prewencja chorób układu krążenia. 1st ed. Medycyna Praktyczna, Kraków 2015: 57–64.
  4. Bress AP, Cohen JB, Anstey DE, et al. Inequities in Hypertension Control in the United States Exposed and Exacerbated by COVID-19 and the Role of Home Blood Pressure and Virtual Health Care During and After the COVID-19 Pandemic. J Am Heart Assoc. 2021; 10(11): e020997.
    CrossRefPubMed
  5. Kreutz R, Dobrowolski P, Prejbisz A, et al. European Society of Hypertension COVID-19 Task Force Review. Lifestyle, psychological, socioeconomic and environmental factors and their impact on hypertension during the coronavirus disease 2019 pandemic. J Hypertens. 2021; 39(6): 1077–1089.
    CrossRefPubMed
  6. Picone DS, Padwal R, Stergiou GS, et al. How to find and use validated blood pressure measuring devices. J Hum Hypertens. 2023; 37(2): 108–114.
    CrossRefPubMed
  7. BP Monitors. https://stridebp.org/bp-monitors (17.07.2022).
  8. Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESHGuidelines for themanagement ofarterial hypertension. J Hypertens. 2018; 36(10): 1953–2041.
    CrossRefPubMed
  9. Beaney T, Schutte AE, Stergiou GS, et al. MMM Investigators*. May Measurement Month 2019: The Global Blood Pressure Screening Campaign of the International Society of Hypertension. Hypertension. 2020; 76(2): 333–341.
    CrossRefPubMed
  10. Figueiredo D, Azevedo A, Pereira M. Definition of hypertension: the impact of number of visits for blood pressure measurement. Rev Port Cardiol. 2009; 28(7–8): 775–783.
    PubMed
  11. Shah NP, Clare RM, Chiswell K, et al. Trends of blood pressure control in the U.S. during the COVID-19 pandemic. Am Heart J. 2022; 247: 15–23.
    CrossRefPubMed
  12. Chamberlain AM, Cooper-DeHoff RM, Fontil V, et al. Disruption in Blood Pressure Control With the COVID-19 Pandemic: The PCORnet Blood Pressure Control Laboratory. Mayo Clin Proc. 2023; 98(5): 662–675.
    CrossRefPubMed
  13. Feitosa FG, Feitosa ADM, Paiva AMG, et al. Impact of the COVID-19 pandemic on blood pressure control: a nationwide home blood pressure monitoring study. Hypertens Res. 2022; 45(2): 364–368.
    CrossRefPubMed
  14. Pengo MF, Albini F, Guglielmi G, et al. Home blood pressure during COVID-19-related lockdown in patients with hypertension. Eur J Prev Cardiol. 2022; 29(3): e94–e96.
    CrossRefPubMed
  15. Burnier M, Kjeldsen SE, Narkiewicz K, et al. Hypertension management during the COVID-19 pandemic: what can we learn for the future? Blood Press. 2022; 31(1): 47–49.
    CrossRefPubMed
  16. Citoni B, Figliuzzi I, Presta V, et al. Home Blood Pressure and Telemedicine: A Modern Approach for Managing Hypertension During and After COVID-19 Pandemic. High Blood Press Cardiovasc Prev. 2022; 29(1): 1–14.
    CrossRefPubMed
  17. Mancia G, Rea F, Ludergnani M, et al. Renin-Angiotensin-Aldosterone System Blockers and the Risk of Covid-19. N Engl J Med. 2020; 382(25): 2431–2440.
    CrossRefPubMed
  18. Reynolds HR, Adhikari S, Iturrate E, et al. Renin-Angiotensin-Aldosterone System Inhibitors and Risk of Covid-19. N Engl J Med. 2020; 382(25): 2441–2448.
    CrossRefPubMed
  19. Laffin LJ, Kaufman HW, Chen Z, et al. Rise in Blood Pressure Observed Among US Adults During the COVID-19 Pandemic. Circulation. 2022; 145(3): 235–237.
    CrossRefPubMed
  20. Wing RR, Venkatakrishnan K, Panza E, et al. Association of COVID-19 Stay-at-Home Orders With 1-Year Weight Changes. JAMA Netw Open. 2022; 5(6): e2217313.
    CrossRefPubMed
  21. Corrigendum to: May Measurement Month 2018: a pragmatic global screening campaign to raise awareness of blood pressure by the International Society of Hypertension. Eur Heart J. 2019; 40(37): 3109.
    CrossRefPubMed
  22. Beaney T, Schutte AE, Tomaszewski M, et al. May Measurement Month 2017: an analysis of blood pressure screening results worldwide. Lancet Glob Healh. 2018; 6(7): e736–e743.
    CrossRefPubMed
  23. Kallioinen N, Hill A, Horswill MS, et al. Sources of inaccuracy in the measurement of adult patients' resting blood pressure in clinical settings: a systematic review. J Hypertens. 2017; 35(3): 421–441.
    CrossRefPubMed
  24. Fan WG, Wang WY, Meng YX, et al. Within-visit and between-visit intra-individual blood pressure variability in an unselected adult population from rural China. J Hypertens. 2021; 39(7): 1346–1351.
    CrossRefPubMed
  25. Parati G, Stergiou GS, Dolan E, et al. Blood pressure variability: clinical relevance and application. J Clin Hypertens (Greenwich). 2018; 20(7): 1133–1137.
    CrossRefPubMed
  26. Wang J, Shi X, Ma C, et al. Visit-to-visit blood pressure variability is a risk factor for all-cause mortality and cardiovascular disease: a systematic review and meta-analysis. J Hypertens. 2017; 35(1): 10–17.
    CrossRefPubMed
  27. Stevens SL, Wood S, Koshiaris C, et al. Blood pressure variability and cardiovascular disease: systematic review and meta-analysis. BMJ. 2016; 354: i4098.
    CrossRefPubMed
  28. Kollias A, Kyriakoulis KG, Stambolliu E, et al. Seasonal blood pressure variation assessed by different measurement methods: systematic review and meta-analysis. J Hypertens. 2020; 38(5): 791–798.
    CrossRefPubMed
  29. Iwahori T, Miura K, Obayashi K, et al. Seasonal variation in home blood pressure: findings from nationwide web-based monitoring in Japan. BMJ Open. 2018; 8(1): e017351.
    CrossRefPubMed
  30. Stergiou GS, Palatini P, Modesti PA, et al. Seasonal variation in blood pressure: Evidence, consensus and recommendations for clinical practice. Consensus statement by the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability. J Hypertens. 2020; 38(7): 1235–1243.
    CrossRefPubMed
  31. Bombelli M, Toso E, Peronio M, et al. The Pamela study: main findings and perspectives. Curr Hypertens Rep. 2013; 15(3): 238–243.
    CrossRefPubMed

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