COVID-19 Infection May Cause Hypertension in Adults With No Pre-Existing Conditions

COVID-19 infection may be significantly linked to persistent high blood pressure (BP), evenamong those with no history of high BP, according to the results of a large study published in Hypertension.

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The retrospective observational study—which compared the impact of COVID-19 versus influenza infection on the development and risk factors associated with hypertension—showed that those hospitalized for COVID-19 were 2 times more likely to develop persistent hypertension than those hospitalized for influenza.

“Given the sheer number of people affected by COVID-19 compared to influenza, these statistics are alarming and suggest that many more patients will likely develop high BP in the future, which may present a major public health burden,” said Tim Q. Duong, PhD, professor of radiology and vice chair for radiology research and associate director of Integrative Imaging and Data Science at the Center for Health and Data Innovation at Albert Einstein College of Medicine and Montefiore Health System in New York City, in a press release.

High BP occurred in 21% of patients hospitalized with COVID-19 and 16% of those hospitalized with influenza. Of those not hospitalized from illness, COVID-19 had a 1.5 times higher likelihood of causing persistent hypertension than influenza, with 11% of patients with COVID-19 developing high persistent BP compared to 4% of those with influenza.

The study cohort included 45,398 patients from the Bronx and greater New York City boroughs who were hospitalized with COVID-19 between March 2020 and August 2022 and 13,864 patients hospitalized with influenza between January 2018 and August 2022. None of the patients had a history of hypertension.

Patients in the study were more likely to be of lower socioeconomic status, which worsens the odds of post-infection high BP. The authors posit that pandemic-related isolation, psychosocial stress, reduced physical activity, poor diet quality, and weight gain are also factors that could lead to hypertension.

In addition, the findings showed that patients who were aged 40 years and older, male, Black, or had preexisting conditions (such as coronary heart disease and chronic kidney disease) had a higher risk of developing high persistent BP after COVID-19. Further, patients who received vasopressor and corticosteroid treatment were more likely to suffer from persistent hypertension following COVID-19 infection.

Study limitations included enrollment of patients who likely had severe COVID-19 or who use the health system more frequently. In addition, some patients may have had undiagnosed high BP. Investigators also did not consider vaccine status on health outcomes or whether all patients had received the vaccine, and unintended patient selection bias.

Follow-up should be done to understand whether these COVID-19-related complications of the heart and BP could be self-regulated. Other follow-up is needed to identify the long-lasting effects of hypertension on the entire cardiovascular system, according to the study authors.

“These findings should heighten awareness to screen at-risk patients for hypertension after COVID-19 illness to enable earlier identification and treatment for hypertension-related complications, such as cardiovascular and kidney disease,” Duong said in the press release.

Reference

COVID-19 may trigger new-onset high blood pressure. American Heart Association. News Release. August 21, 2023. Accessed on August 29, 2023. https://newsroom.heart.org/news/covid-19-may-trigger-new-onset-high-blood-pressure