Association Between Blood Pressure Control and Coronavirus Disease 2019 Outcomes in 45 418 Symptomatic Patients With Hypertension

Sheppard, James P; Nicholson, Brian D; Lee, Joseph; McGagh, Dylan; Sherlock, Julian; Koshiaris, Constantinos; Oke, Jason; Jones, Nicholas; Hinton, William; Armitage, Laura C; Hecke, Oliver van; Lay-Flurrie, Sarah; Bankhead, Clare; Liyanage, Harshana; Williams, John; Ferreira, Filipa; Feher, Michael; Ashworth, Andrew; Joy, Mark; Lusignan, Simon de; Hobbs, F D Richard

doi:10.1161/hypertensionaha.120.16472

Cited by 51 publications

(46 citation statements)

References 24 publications

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“…Current findings from Sheppard et al [ 12 ] show that patients with BP < 130/80 mm Hg had higher odds of COVID-19 death than patients with BP 140/90–159/99 mm Hg. BP values 130/80–139/89 mmHg and BP ≥ 160/100 mmHg were not associated with COVID-19-related death.…”

Section: Discussionmentioning

confidence: 98%

COVID-19 Causing Hypotension in Frail Geriatric Hypertensive Patients?

Koudelka

Sovová

2021

Medicina

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Background: The association of coronavirus disease 2019 (COVID-19) with hypertension has been one of the frequently discussed topics in current studies since hypertension was identified as a risk factor for coronavirus disease. However, no studies seem to be focused on the BP (blood pressure) in patients with hypertension after COVID-19. Report: This report presents the cases of five frail geriatric patients (avg. age 78.3 (±6.4) years) with sarcopenia and controlled hypertension (office BP < 140 mmHg) who were diagnosed with SARS-CoV-2. Findings: Control ABPM performed after COVID-19 showed that these hypertensive patients were hypotensive and that the previously well-established therapy was suddenly too intensive for them. Conclusions: These findings suggest that BP control after COVID-19 is needed and that ABPM is, particularly in frail geriatric patients, by no means a luxury but a necessity.

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Section: Discussionmentioning

confidence: 98%

COVID-19 Causing Hypotension in Frail Geriatric Hypertensive Patients?

Koudelka

Sovová

2021

Medicina

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“…The role of hypertension in acute COVID-19 is not clear - initially reported as a possible risk factor for severe COVID-19 (in excess in severe versus nonsevere cases)(37), has not been shown to be a robust predictor of severity with age-hypertension interactions even decreasing risk(35) and improved blood pressure control correlating to worse outcomes (38). Antihypertensive medications may impact disease course, with preliminary results indicating effects that may vary by race(39).…”

Section: Discussionmentioning

confidence: 99%

High proportion of post-acute sequelae of SARS-CoV-2 infection in individuals 1-6 months after illness and association with disease severity in an outpatient telemedicine population

O’Keefe

Minton

Morrow

et al. 2021

Preprint

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Background Individuals with coronavirus disease 2019 (COVID-19) may have persistent symptoms following their acute illness. The prevalence and predictors of these symptoms, termed post-acute sequelae of SARS-CoV-2 (PASC), are not fully described. Methods Participants discharged from an outpatient telemedicine program for COVID-19 were emailed a survey (1-6 months after discharge) about ongoing symptoms, acute illness severity, and quality of life. Standardized telemedicine notes from acute illness were used for covariates (comorbidities and provider-assessed symptom severity). Bivariate and multivariable analyses were performed to assess predictors of persistent symptoms. Results Two hundred and ninety patients completed the survey, of whom 115 (39.7%) reported persistent symptoms including fatigue (n= 59, 20.3%), dyspnea on exertion (n=41, 14.1%), and mental fog (n=39, 13.5%) among others. Proportion of persistent symptoms did not differ based on duration since illness (<90 days: n=32, 37.2% versus >90 days: n=80, 40.4%, p = 0.61). Predictors of persistent symptoms included provider-assessed moderate-severe illness (aOR 3.24, 95% CI 1.75, 6.02), female sex (aOR 1.99 95% 0.98, 4.04; >90 days out: aOR 2.24 95% CI 1.01, 4.95), and middle age (aOR 2.08 95% CI 1.07, 4.03). Common symptoms associated with reports of worse physical health included weakness, fatigue, myalgias, and mental fog. Conclusions Symptoms following acute COVID-19 are common and may be predicted by factors during the acute phase of illness. Fatigue and neuropsychiatric symptoms figured prominently. Select symptoms seem to be particularly associated with perceptions of physical health following COVID-19 and warrant specific attention on future studies of PASC.

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“…Initial studies at the onset of the pandemic reported high prevalence of hypertension and other comorbidities and mortality from COVID-19 (77,78). In a case-series study of 5,700 patients with COVID-19 in New York, hypertension (56.6%), obesity (41.7%), and diabetes (33.8%) were the most frequent comorbidities (77).…”

Section: Hypertensionmentioning

confidence: 99%

“…show that patients with COVID-19 and hypertension have a higher mortality risk when compared with non-hypertensives (77)(78)(79).…”

Section: Hypertensionmentioning

confidence: 99%

Cardiovascular and Renal Risk Factors and Complications Associated With COVID-19

et al. 2021

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The current COVID-19 pandemic, caused by the SARS-CoV-2 virus (Severe Acute Respiratory Syndrome-Coronavirus-2), represents the largest medical challenge in decades. It has exposed unexpected cardiovascular vulnerabilities at all stages of the disease (pre-infection, acute phase and subsequent chronic phase). The major cardiometabolic drivers identified to have epidemiological and mechanistic associations with COVID-19 are abnormal adiposity, dysglycemia, dyslipidemia, and hypertension. Hypertension is of particular interest, because components of the renin-angiotensin system (RAS), which are critically involved in the pathophysiology of hypertension, are also implicated in COVID-19. Specifically ACE2, a multifunctional protein of the RAS, which is part of the protective axis of the RAS, is also the receptor through which SARS-CoV-2 enters host cells causing viral infection. Cardiovascular and cardiometabolic co-morbidities not only predispose to COVID-19, but are complications of SARS-CoV-2 infection. In addition, increasing evidence indicates that acute kidney injury is common in COVID-19, that it occurs early and in temporal association with respiratory failure and is associated with poor prognosis, especially in the presence of cardiovascular risk factors. Here we discuss cardiovascular and kidney disease in the context of COVID-19 and provide recent advances on putative pathophysiological mechanisms linking cardiovascular disease and COVID-19, focusing on the RAS and ACE2 as well as the immune system and inflammation. We provide up-to-date information on the relationship between hypertension, diabetes, and COVID-19 and emphasize the major cardiovascular diseases associated with COVID-19. We also briefly discuss emerging cardiovascular complications associated with long COVID-19, notably postural tachycardia syndrome (POTS).

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Association Between Blood Pressure Control and Coronavirus Disease 2019 Outcomes in 45 418 Symptomatic Patients With Hypertension

Cited by 51 publications

References 24 publications

COVID-19 Causing Hypotension in Frail Geriatric Hypertensive Patients?

COVID-19 Causing Hypotension in Frail Geriatric Hypertensive Patients?

High proportion of post-acute sequelae of SARS-CoV-2 infection in individuals 1-6 months after illness and association with disease severity in an outpatient telemedicine population

Cardiovascular and Renal Risk Factors and Complications Associated With COVID-19

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