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Covid-19 infection was significantly associated with the development of persistent hypertension among those with no prior history of high blood pressure, according to new research.
The retrospective observational study is the first to investigate the development and risk factors associated with persistent high blood pressure in people with Covid-19 infection compared to influenza, a similar respiratory virus.
Data were analysed from electronic medical records at the Montefiore Health System in Bronx, New York, which serves a large, racially and ethnically diverse population. The study included 45,398 people with Covid-19 — hospitalised between March 1, 2020 and February 20, 2022 — and 13,864 people with influenza without Covid-19 — hospitalised between January 2018 and February 20, 2022 — who returned to the hospital system for any medical reasons within an average follow-up period of six months.
The analysis was published in Hypertension and found 21% of people hospitalised with Covid-19 and 11% of those who were not hospitalised for Covid-19 developed high blood pressure, compared to 16% of people hospitalised with influenza and 4% of those not hospitalised for influenza.
People hospitalised for Covid-19 were more than twice as likely and those not hospitalised are 1.5 times more likely to develop persistent hypertension compared to people hospitalised and non-hospitalised with influenza, respectively.
More patients will likely develop persistent hypertension in the future
Senior study author Tim Q Duong, professor of radiology and vice chair for radiology research at Albert Einstein College of Medicine and Montefiore Health System in New York City, said: “While Covid-19 is typically more severe in patients with preexisting high blood pressure, including higher rates of hospitalisation and mortality compared to people with normal blood pressure, it is unknown whether the SARS-CoV-2 virus may trigger the development of high blood pressure or worsen preexisting hypertension.
“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 blood pressure in the future, which may present a major public health burden.
“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.”
The analysis also found that people infected with Covid-19 who were over 40 years old, Black adults or those with preexisting conditions, such as chronic obstructive pulmonary disease, coronary artery disease or chronic kidney disease, had an elevated risk of developing high blood pressure.
The authors noted that the people in the study were primarily from communities with low socioeconomic status, which may increase their susceptibility to developing high blood pressure after Covid-19 infection. Other factors may also have contributed to the development of high blood pressure in the study patients, including the effects of isolation, psychosocial stress, reduced physical activity, unhealthy diet and weight gain during the Covid-19 pandemic.
Researchers also noted that longer follow-up studies will be needed to determine whether the effects of Covid-19-related complications on the heart and blood pressure regulation may resolve on their own, or if there may be long-lasting effects on patients’ cardiovascular systems.