What is the clinical evidence from this study?

Study design: Observational. Population: Hypertension (n=95). Intervention: Female gender vs. Male gender. Primary outcome: Pandemic-related traumatic stress symptoms (PRTS+) (OR 5.51, 95% CI 1.42-21.42).

December 13, 2023Open Access

Post-traumatic stress in older, community-dwelling adults with hypertension during the COVID-19 pandemic: An investigation of pre-pandemic sociodemographic, health, and vascular and inflammatory biomarker predictors

Key Result

Female gender and greater pre-pandemic anxiety significantly increased the odds of experiencing pandemic-related traumatic stress symptoms in older adults with hypertension.

Study Design

Type

Observational (n=95)

Multicenter

Structured PICO

Population

95 community-dwelling older adults aged 61-92 years with hypertension, previously enrolled in a healthy aging trial, assessed for pandemic-related traumatic stress during the COVID-19 pandemic.

Comparator

Participants without pandemic-related traumatic stress symptoms (PRTS-) (n=55)

Outcome

Pandemic-related traumatic stress symptoms (PRTS) assessed using the Primary Care PTSD Screen (PC-PTSD) during the COVID-19 pandemicpatient reported

In older adults with hypertension, pre-pandemic anxiety and female gender, but not vascular inflammation biomarkers, predicted pandemic-related traumatic stress during the COVID-19 pandemic.

Main Result

Odds Ratio: 5.51 (95% CI 1.42–21.42)

Limitations

Selection bias from recruiting participants previously enrolled in a clinical trial
Non-respondents were older and had lower cognitive scores
Predominantly Caucasian and college-educated sample
Use of a modified 4-item self-report measure (PC-PTSD) rather than clinical interviews
Small sample size may have been underpowered to detect smaller effects

Abstract

COVID-19 pandemic-related traumatic stress (PRTS) symptoms are reported in various populations, but risk factors in older adults with chronic medical conditions, remain understudied. We therefore examined correlates and pre-pandemic predictors of PRTS in older adults with hypertension during COVID-19. Participants in California, aged 61–92 years ( n = 95), participated in a pre-pandemic healthy aging trial and later completed a COVID-19 assessment (May to September 2020). Those experiencing ⩾1 PRTS symptom ( n = 40), and those without PRTS symptoms ( n = 55), were compared. The PRTS+ group had poorer mental and general health and greater impairment in instrumental activities of daily living. Pre-pandemic biomarkers of vascular inflammation did not predict increased odds of PRTS; however, greater pre-pandemic anxiety and female gender did predict PRTS during COVID-19. Our findings highlight PRTS as a threat to healthy aging in older adults with hypertension; targeted approaches are needed to mitigate this burden, particularly for females and those with pre-existing anxiety.

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