COVID-19 Pandemic Associated With Higher Blood Pressure Across the United States

Blood pressure control deteriorated in both men and women with the onset of the COVID-19 pandemic in the United States in 2020. Women and older adults had the highest blood pressure readings during the pandemic.

The COVID-19 pandemic is linked to higher blood pressure levels in middle-aged adults in the US, according to new research published Dec. 6, 2021 in the American Heart Association’s flagship journal Circulation.

According to the American Heart Association, nearly half of American adults have high blood pressure, a leading cause of heart disease, and nearly 75% of all cases remain above recommended blood pressure levels. In response to the COVID-19 pandemic, stay-at-home orders were implemented across the US between March and April 2020. This resulted in a shift to remote care for a host of chronic health conditions, including high blood pressure, and negatively impacted healthy lifestyles for many people.

“At the beginning of the pandemic, most people were not taking good care of themselves. Elevations in blood pressure were likely related to changes in dietary habits, increased alcohol consumption, decreased physical activity, decreased adherence to treatment, increased emotional stress and poor sleep,” said lead study author Luke J. Laffin, MD, co-director of the Center. for blood pressure disorders at the Cleveland Clinic in Cleveland, Ohio. “And we know that even a small increase in blood pressure increases the risk of stroke and other adverse cardiovascular diseases.”

For this analysis, researchers accessed anonymized health data from an employee wellness program (including employees and spouses/partners) to assess changes in blood pressure levels before and during the COVID-19 pandemic. The data includes nearly half a million adults in the US, average age of 46, 54% women, who had their blood pressure measured every year from 2018 to 2020 during an employee health survey. The participants were divided into four groups: normal, elevated, stage 1 hypertension, and stage 2 hypertension based on current American Heart Association blood pressure guidelines.

The researchers compared monthly mean blood pressure readings between 2018 and 2019 and blood pressure readings from January through March 2019 to January through March 2020 (pre-pandemic). They then assessed blood pressure changes compared to April to December 2020 (during the pandemic) with April to December 2019 (pre-pandemic).

The analysis found:

During the pandemic (April to December 2020), the average rise in blood pressure each month ranged from 1.10 to 2.50 mm Hg higher for systolic blood pressure (the highest number in a blood pressure reading that indicates how much pressure the blood is exerting against the artery walls with each contraction) and 0.14 to 0.53 mm Hg for diastolic blood pressure (the bottom number in a blood pressure reading indicates how much pressure the blood exerts against the artery walls while the heart is resting, between contractions) compared to the same time period in 2019. Before the pandemic, blood pressure readings were largely unchanged when comparing study years. Higher elevations in blood pressure readings were seen in women for both systolic and diastolic blood pressure, in older participants for systolic blood pressure, and in younger participants for diastolic blood pressure. From April to December 2020, compared to the pre-pandemic period, more participants (26.8%) were recategorized to a higher blood pressure category, while only 22% of participants moved to a lower blood pressure category.

“From a public health perspective, it is important to get vaccinated and wear a mask during a pandemic. However, the results of our study reinforce the need to also consider chronic health problems such as the deterioration of blood pressure,” Laffin said. “Even in the midst of the pandemic, it is important to pay attention to your blood pressure and your chronic medical conditions. “Get regular exercise, eat a healthy diet, and monitor your blood pressure and cholesterol. See your doctor regularly to learn how to manage your cardiovascular risk factors.”

The study authors are following up on these results to find out if this trend continues into 2021, which could indicate an imminent wave of strokes and heart attacks.

“Unfortunately, this research confirms what is being seen across the country – the COVID-19 pandemic has had and will continue to have far-reaching health implications across the country and in particular related to uncontrolled hypertension,” said Eduardo Sanchez, MD, MPH, FAAFP, FAHA, the American Heart Association’s Chief Medical Officer for Prevention. “These results confirm why the American Heart Association’s National Hypertension Control Initiative (NHCI) is critical. With a particular focus on historically under-resourced communities in the United States, the comprehensive program supports teams in health centers across the United States. community through regular blood pressure management training, technical assistance and resources, including appropriate blood pressure measurement technique, self-measured blood pressure monitoring and management, adherence and healthy lifestyle services.”

The main limitation of the study is that the main cause of higher blood pressure is not clear. In addition, the study’s findings may not be representative of adults who do not participate in an employee wellness program.

Reference: “Blood Pressure Rise Observed in U.S. Adults During the COVID-19 Pandemic” by Luke J. Laffin, Harvey W. Kaufman, Zhen Chen, Justin K. Niles, Andre R. Arellano, Lance A. Bare, and Stanley L Hazen, December 6, 2021, Edition.
DOI: 10.1161 / CIRCULATIONAHA.121.057075

Co-authors are Harvey W. Kaufman, MD, MBA; Zhen Chen, MS; Justin K. Niles, MA; Andre R. Arellano, BS; Lance A. Bare, Ph.D.; and Stanley L. Hazen, MD, Ph.D.