How the COVID-19 pandemic has impacted blood pressure management in the US
Hypertension patients measured their blood pressure less frequently during the early months of the COVID-19 pandemic, according to new research published in Hypertension.[1] In addition, when those patients did measure their blood pressure, the readings were less healthy than they had been before the pandemic.
The new analysis represents a collaboration between specialists from Cedars-Sinai in Los Angeles, Columbia University Irving Medical Center in New York City and Tulane University School of Medicine in New Orleans. The group examined electronic health record (EHR) data from more than 137,000 adult patients who were seen my a medical professional from August 2018 to January 2019 and again from February 2019 to January 2020. Data from these prepandemic periods were compared to data gathered from April 2020 to November 2020, when the pandemic had been underway for a few months and stay-at-home orders were in place. The mean participant age was 66.2 years old, and 57.2% were female.
Overall, 77.8% of patients had controlled blood pressure—a systolic blood pressure of less than 140 mmHg and a diastolic blood pressure of less than 90 mmHg—before the pandemic. That figure decreased by 3.43 percentage points after the start of the pandemic. In addition, patients measured their blood pressure less frequently once the pandemic started, likely due to the stress and limited access to healthcare associated with following stay-at-home orders for an extended period of time.
Another key change from those prepandemic months to the early months of the COVID was that the mean pooled systolic blood pressure increased by 1.79 mmHg and the mean diastolic blood pressure increased by 1.30 mmHg.
Though this is a relatively small increase, the authors emphasized that it could still make a significant impact for this patient population, increasing their risk of a myocardial infarction or stroke.
“We had a unique opportunity to examine the pandemic’s impact on hypertension management among a large, diverse group of people from three major cities,” lead author Hiroshi Gotanda, MD, PhD, an assistant professor of medicine at Cedars-Sinai, said in a prepared statement. “Our analysis revealed similar patterns among participants from three different regions and a variety of racial, ethnic and socioeconomic backgrounds.”
“It is critical to increase access to healthcare, potentially through telemedicine and home blood pressure monitoring, to mitigate disruptions in care during future large-scale emergencies,” added senior author Teryl Nuckols, MD, MSHS, director of the division of general internal medicine in the Cedars-Sinai Department of Medicine. “We want to avoid compounding the effects of widespread disasters by creating additional public health crises.”
The team’s analysis was funded by a grant from the National Heart, Lung and Blood Institute.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.