Key result
Controlled pre-admission blood pressure in COVID-19 is linked to ~48% less hypoxemia but more nephropathy signs.
Why the study?
SARS-CoV-2 can directly affect the cardiovascular system, and it is unclear whether conventional blood pressure control is associated with COVID-19 severity in hypertensive patients.
Does controlled blood pressure (<140/90 mmHg) improve COVID-19 severity in hospitalized patients with hypertension and COVID-19?
Observational (n=163)
No
Does controlled blood pressure (<140/90 mmHg) improve COVID-19 severity in hospitalized patients with hypertension and COVID-19?
Absolute Event Rate: 18.1% vs 34.8%
p-value: p=0.02
In patients with COVID-19 and hypertension, prior blood pressure control <140/90 mmHg is associated with less severe pulmonary injury but a higher frequency of nephropathy signs.
May suggest pulmonary-renal trade-offs with pre-admission BP control in hypertensive COVID-19; hypothesis-generating and should not yet change practice.
SARS-CoV-2 virus, which causes coronavirus disease 2019 (COVID-19), apart from respiratory manifestations, is able to directly affect the cardiovascular system. Therefore, different from general population target values of blood pressure might be beneficial for the patients with COVID-19. The aim of this study was to investigate whether conventional blood pressure control was associated with the severity of COVID-19. From 260 patients that were hospitalised to the unit subdivision of stable patients of COVID-center between March, 2020, and December, 2020, 163 patients with confirmed infection with SARS-CoV-2 virus and hypertension were selected. The patients were distributed by hypertension control: blood pressure <140/90 mmHg (n=94) and blood pressure ≥140/90 mmHg (n=69). Routine instrumental and laboratory investigations were registered and analysed. The patients were diagnosed and treated according to national and European guidelines. The information about the control of blood pressure was taken from the patients’ medical records. The group of patients with controlled hypertension had higher prevalence of females (p=0.03), 10 years higher median of age (p<0.01) and lower frequency of obesity (p=0.04). The patients with controlled hypertension had lower median of pulmonary injury (p=0.04) and lower frequency of SpO2<92% (p=0.02). Glomerular filtration rate <60 ml/min and proteinuria were detected significantly more frequently in the patients with controlled hypertension (p=0.02). In the presented study blood pressure below 140/90 mmHg before the admission to the hospital was associated with a lower degree of pulmonary injury but with the higher frequency of nephropathy signs. Urine test and blood creatinine monitoring might be beneficial for the patients with COVID-19 and hypertension.
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Kuryata et al. (2023) conducted an observational in COVID-19 and arterial hypertension (n=163). Controlled blood pressure (<140/90 mmHg) vs. Uncontrolled blood pressure (≥140/90 mmHg) was evaluated on SpO2 <92% (p=0.02). Controlled blood pressure (<140/90 mmHg) before hospital admission in COVID-19 patients was associated with a lower frequency of SpO2 <92% (18.1% vs 34.8%, p=0.02) but higher rates of nephropathy signs.
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