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COVID-19 infection in hypertensive patients increases arterial stiffness, leading to higher systolic blood pressure and a greater need for antihypertensive medications. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

November 1, 2025Internal and Emergency Medicine1 citationsOpen Access

COVID-19 induces greater difficulty in blood pressure control due to increased arterial stiffness

MMMarialuisa Sveva MarozziUniversity of Bari Aldo Moro IFIlaria FucileUniversity of Naples Federico II IPImmacolata PanettieriOspedali Riuniti di Foggia

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Abstract

COVID-19 infection induces widespread endotheliitis, with long-term effects on the vascular system and arterial hypertension that are still under investigation. This study verified the possible correlation between COVID-19 infection and blood pressure control. In the multicenter study presented here, we enrolled 185 hypertensive patients with a positive nasopharyngeal swab for SARS-CoV-2 in the 6 months prior to the follow-up visit (Group 1, 90F, age 63.38 ± 10.29 years) and 97 hypertensive patients consistently negative for SARS-CoV-2 (Group 2, 49F, age 64.20 ± 10.79 years), overlapping in terms of age, sex, weight, and Body Mass Index (BMI). We evaluated the follow-up visit within 12 months (T1) and the one prior to the infection (T0). Group 2 had a higher percentage of patients with dyslipidemia and a significantly lower percentage of patients with hypertensive cardiomyopathy (HTN-CM) compared to Group 1. In Group 1, we observed a significant decrease in the number of smokers and an increase in the diagnosis of HTN-CM at T1, with a significant increase in systolic values (134.30 ± 14.93 mmHg vs 132.40 ± 16.19 mmHg, p < 0.05) and a decrease in diastolic values (78.30 ± 8.77 mmHg vs 79.63 ± 8.41 mmHg, p < 0.05) compared to T0. Moreover, there was a significant increase in the number of antihypertensive drugs taken at T1 in Group 1, particularly angiotensin-receptor blockers, compared to T0. Finally, at T1 in Group 1, we observed a significant increase in pulse wave velocity (PWV) compared to T0. These findings were absent in Group 2. Patients who contracted the COVID-19 infection showed increased vascular stiffness, hence higher blood pressure values, and needed a greater number of medications for blood pressure control.

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