Shuyuan Zhang1, Xiaoyang Zhou2, Youren Chen3, Lixin Wang4, Bingpo Zhu5,6, Yinong Jiang7, Peili Bu8, Wei Liu9, Dianfang Li10, Yuming Li11, Yanhua Tao12, Jie Ren13, Li Fu14, Yufeng Li15, Xiaomei Shen16, Hualing Liu17, Gang Sun18, Xinjuan Xu19, Jingjing Bai1, Weili Zhang1, Jun Cai1. 1. State Key Laboratory of Cardiovascular Disease, Hypertension Center, FuWai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China (S.Z., J.B., W.Z., J.C.). 2. Renmin Hospital of Wuhan University, Hubei, China (X.Z.). 3. The Second Affiliated Hospital to Medical College Shantou University, Guangdong, China (Y.C.). 4. The First Affiliated Hospital of Hebei North University, Zhangjiakou, China (L.W.). 5. Kang Ya Hospital, Yiyang, Hunan, China (B.Z.). 6. Southern University of Science and Technology Hospital, Shenzhen, China (B.Z.). 7. The 1st Affiliated Hospital of Dalian Medical University, Liaoning, China (Y.J.). 8. Qilu Hospital of Shandong University, Jinan, China (P.B.). 9. Beijing Hospital, China (W.L.). 10. Hongxinglong Center Hospital, Shuangyashan, Heilongjiang, China (D.L.). 11. Pingjin Hospital, Logistics University of PAPF, Tianjin, China (Yuming Li). 12. Nanchang Sixth Hospital, Jiangxi, China (Y.T.). 13. Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, China (J.R.). 14. Benxi Railway Hospital, Liaoning, China (L.F.). 15. Beijing Pinggu Hospital, China (Yufeng Li). 16. First Hospital of Shanxi Medical University, Taiyuan, China (X.S.). 17. Zhoukou City Central Hospital, Henan, China (H.L.). 18. The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia, China (G.S.). 19. First Affiliated Hospital of Xinjiang Medical University, Urumqi, China (X.X.).
Abstract
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has impacted clinical care worldwide. Evidence of how this health crisis affected common conditions like blood pressure (BP) control is uncertain. METHODS: We used longitudinal BP data from an ongoing randomized clinical trial to examine variations in home BP monitored via a smartphone-based application (app) in a total of 7394 elderly patients with hypertension aged 60 to 80 years stratified by their location in Wuhan (n=283) compared with other provinces of China (n=7111). Change in morning systolic BP (SBP) was analyzed for 5 30-day phases during the pandemic, including preepidemic (October 21 to November 20, 2019), incubation (November 21 to December 20, 2019), developing (December 21, 2019 to January 20, 2020), outbreak (January 21 to February 20, 2020), and plateau (February 21 to March 21, 2020). RESULTS: Compared with non-Wuhan areas of China, average morning SBP (adjusted for age, sex, body mass index) in Wuhan patients was significantly higher during the epidemic growth phases, which returned to normal at the plateau. Between-group differences in ΔSBP were +2.5, +3.0, and +2.1 mm Hg at the incubation, developing, and outbreak phases of COVID-19 (P<0.001), respectively. Sensitivity analysis showed a similar trend in trajectory pattern of SBP in both the intensive and standard BP control groups of the trial. Patients in Wuhan also had an increased regimen change in antihypertensive drugs during the outbreak compared with non-Wuhan patients. Expectedly, Wuhan patients were more likely to check their BP via the app, while doctors were less likely to monitor the app for BP control during the pandemic. CONCLUSIONS: Our data demonstrate that the COVID-19 pandemic was associated with a short-term increase in morning SBP among elderly patients with hypertension in Wuhan but not other parts of China. Further study will be needed to understand if these findings extended to other parts of the world substantially affected by the virus. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT03015311.
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has impacted clinical care worldwide. Evidence of how this health crisis affected common conditions like blood pressure (BP) control is uncertain. METHODS: We used longitudinal BP data from an ongoing randomized clinical trial to examine variations in home BP monitored via a smartphone-based application (app) in a total of 7394 elderly patients with hypertension aged 60 to 80 years stratified by their location in Wuhan (n=283) compared with other provinces of China (n=7111). Change in morning systolic BP (SBP) was analyzed for 5 30-day phases during the pandemic, including preepidemic (October 21 to November 20, 2019), incubation (November 21 to December 20, 2019), developing (December 21, 2019 to January 20, 2020), outbreak (January 21 to February 20, 2020), and plateau (February 21 to March 21, 2020). RESULTS: Compared with non-Wuhan areas of China, average morning SBP (adjusted for age, sex, body mass index) in Wuhan patients was significantly higher during the epidemic growth phases, which returned to normal at the plateau. Between-group differences in ΔSBP were +2.5, +3.0, and +2.1 mm Hg at the incubation, developing, and outbreak phases of COVID-19 (P<0.001), respectively. Sensitivity analysis showed a similar trend in trajectory pattern of SBP in both the intensive and standard BP control groups of the trial. Patients in Wuhan also had an increased regimen change in antihypertensive drugs during the outbreak compared with non-Wuhan patients. Expectedly, Wuhan patients were more likely to check their BP via the app, while doctors were less likely to monitor the app for BP control during the pandemic. CONCLUSIONS: Our data demonstrate that the COVID-19 pandemic was associated with a short-term increase in morning SBP among elderly patients with hypertension in Wuhan but not other parts of China. Further study will be needed to understand if these findings extended to other parts of the world substantially affected by the virus. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT03015311.
Authors: Ana Lear-Claveras; Bárbara Oliván-Blázquez; Ana Clavería; Sabela Couso-Viana; Jesús Puente-Comesaña; Rosa Magallón Botaya Journal: Int J Public Health Date: 2022-08-25 Impact factor: 5.100