Abstract TH162: Worsening Diastolic Hypertension during the COVID-19 Pandemic

Background: COVID-19 is associated with poorer blood pressure (BP) control. However, the trend of hypertension (HTN) during the COVID-19 pandemic is unclear. We aim to examine the association of periods related to the COVID-19 pandemic with BP control. Method: A retrospective cross-sectional study using data from the 2017 - 2023 NHANES included adult participants with available BP readings 1 – 3 measurements. The study populations were categorized into 2 groups: the participants with BP readings before (2017-2020) and during (2021-2023) the pandemic period. Systolic and diastolic HTN (SHTN and DHTN) defined by SBP and DBP ≥130 and ≥80 mmHg, respectively between 2 groups were examined by multiple logistic regression. Results: Of 17,846 adult participants, the mean age±SDwas 51±19 years and 53% were female. Up to 54% had BP measurements before the pre-pandemic period (group 1), and the remaining individuals had BP measurements during the pandemic (group 2). Compared to group 2, group 1 had significantly higher SBP (SBPpre 124±19; SBPduring 122±18 mmHg; meandiff 1.81, 95%CI 1.184, 2.43; Figure 1A); however, they had lower DBP but not statistically significant (DBPpre 74±11; DBPduring 74±12(Figure 1B); meandiff -0.07, 95%CI -0.45, 0.31; Figure 2A, 2B). Group 2 had 17% significantly lower odds of having SHTN compared to group 1 (ORSHTN 0.83; 95%CI 0.77, 0.89, P <0.0001), but had 5% lower odds of DHTN with no statistical significance (ORDHTN 0.95; 0.88, 1.02; P 0.186; Figure 3A, 3B). After adjusting for age (< vs. ≥65 years), gender, race/ethnicity, level of education, ratio of family income to poverty, marital status, and an interaction term between age and gender, group 2 remained to have significantly lower odds of having SHTN compared to group 1 (aORSHTN 0.84; 95%CI 0.77, 0.92, P <0.0001); however, group 2 had higher odds of having DHTN (aORDHTN 1.09; 95%CI 1.01, 1.19, P 0.037). There were effect modifications with higher odds of having SHTN and DHTN observed in elderly women (Pinteraction <0.0001). Conclusions: There was a lower likelihood of having SHTN, but a higher possibility of having DHTN, especially in elderly women during the pandemic period compared to before the pandemic. Factors related to DHTN especially lifestyle changes such as exercise during the pandemic may contribute to these findings and further longitudinal studies are required to elucidate the mechanism.