April 3, 2025Journal of Hypertension10 citationsOpen Access

Long-term effects of SARS-CoV-2 infection on blood vessels and blood pressure – LOCHINVAR

SLStefanie Lip TTTran Tran RHRebecca Hanna

Structured PICO

Does SARS-CoV-2 infection increase future hypertension risk and endothelial dysfunction in nonhypertensive adults?

Population

97 adults (aged 30-60 years) without a history of hypertension and not on antihypertensive medications. Cases (n=37) were hospital-admitted COVID-19 survivors, and controls (n=60) had negative SARS-CoV-2 antibody tests. Median age 49-50 years.

Intervention

Hospital-admitted SARS-CoV-2 infection (COVID-19 survivors)

Comparator

Nonhypertensive controls with negative SARS-CoV-2 antibody tests

Outcome

Change in average 24-h ambulatory blood pressure monitoring (ABPM) systolic blood pressure (SBP) at 12 months from baselinesurrogate

Hospitalized COVID-19 survivors without prior hypertension exhibit persistent vascular dysfunction and increased ambulatory blood pressure at 12 months, highlighting a potential long-term risk for cardiovascular disease.

Abstract

OBJECTIVE: The COVID-19 pandemic has been linked to endothelial dysfunction and renin-angiotensin-aldosterone system (RAAS) dysregulation, potentially worsening hypertension. Longitudinal studies are needed to establish COVID-19's lasting effects on blood pressure (BP) and endothelial function. Our objective was to determine whether COVID-19 increases future hypertension risk by comparing BP and endothelial function in nonhypertensive COVID-19 survivors with nonhypertensive controls. METHODS: This single-centre prospective longitudinal study included participants without hypertension history, with cases being hospital-admitted COVID-19 survivors and controls having negative SARS-CoV-2 antibody tests. Ambulatory blood pressure monitoring, flow-mediated dilatation (FMD), 6-min walk test (6MWT), and quality of life (QoL) assessments were conducted at baseline and 12 months. RAAS phenotyping was performed at baseline. Data analysis used paired t-tests and multivariable regression on full and per-protocol datasets. RESULTS: The full ( n = 97) and per-protocol ( n = 66) datasets included 37 and 15 cases respectively. Median ages (IQR: interquartile range) were 49.0 (43.0-53.5) and 50.0 (42-54.0) years. Baseline RAAS parameters were similar. Multivariable adjusted analyses in the per-protocol group showed SARS-CoV-2 positive participants had a 12-month increase in mean systolic BP (4.57 mmHg, 95% CI -0.04 to 9.18, P = 0.052), diastolic BP (4.46 mmHg 1.01 to 7.90, P = 0.012), decrease in FMD (-3.15% -6.33 to 0.04, P = 0.053) and improvement in 6MWT (145.6 m 49.1 to 242.1, P = 0.004) compared to controls. QoL assessments indicated continued challenges for recovered COVID-19 individuals at 12 months. CONCLUSIONS: Persistent vascular dysfunction and BP increase post-COVID-19 underscore the need for further studies on the long-term risk of hypertension and cardiovascular disease. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/study/NCT05087290.

Demander à l'IA

Bookmark

View Full Paper