Association Between Blood Pressure Control and Coronavirus Disease 2019 Outcomes in 45 418 Symptomatic Patients With Hypertension: An Observational Cohort Study

Hypertension has been identified as a risk factor for coronavirus disease 2019 (COVID-19) and associated adverse outcomes. This study examined the association between preinfection blood pressure (BP) control and COVID-19 outcomes using data from 460 general practices in England. Eligible patients we...

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Veröffentlicht in:Hypertension (Dallas, Tex. 1979) Tex. 1979), 2021-03, Vol.77 (3), p.846-855
Hauptverfasser: Sheppard, James P., Nicholson, Brian D., Lee, Joseph, McGagh, Dylan, Sherlock, Julian, Koshiaris, Constantinos, Oke, Jason, Jones, Nicholas R., Hinton, William, Armitage, Laura, Van Hecke, Oliver, Lay-Flurrie, Sarah, Bankhead, Clare R., Liyanage, Harshana, Williams, John, Ferreira, Filipa, Feher, Michael D., Ashworth, Andrew J., Joy, Mark P., de Lusignan, Simon, Hobbs, F.D. Richard
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container_issue 3
container_start_page 846
container_title Hypertension (Dallas, Tex. 1979)
container_volume 77
creator Sheppard, James P.
Nicholson, Brian D.
Lee, Joseph
McGagh, Dylan
Sherlock, Julian
Koshiaris, Constantinos
Oke, Jason
Jones, Nicholas R.
Hinton, William
Armitage, Laura
Van Hecke, Oliver
Lay-Flurrie, Sarah
Bankhead, Clare R.
Liyanage, Harshana
Williams, John
Ferreira, Filipa
Feher, Michael D.
Ashworth, Andrew J.
Joy, Mark P.
de Lusignan, Simon
Hobbs, F.D. Richard
description Hypertension has been identified as a risk factor for coronavirus disease 2019 (COVID-19) and associated adverse outcomes. This study examined the association between preinfection blood pressure (BP) control and COVID-19 outcomes using data from 460 general practices in England. Eligible patients were adults with hypertension who were tested or diagnosed with COVID-19. BP control was defined by the most recent BP reading within 24 months of the index date (January 1, 2020). BP was defined as controlled (
doi_str_mv 10.1161/HYPERTENSIONAHA.120.16472
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Richard</creator><creatorcontrib>Sheppard, James P. ; Nicholson, Brian D. ; Lee, Joseph ; McGagh, Dylan ; Sherlock, Julian ; Koshiaris, Constantinos ; Oke, Jason ; Jones, Nicholas R. ; Hinton, William ; Armitage, Laura ; Van Hecke, Oliver ; Lay-Flurrie, Sarah ; Bankhead, Clare R. ; Liyanage, Harshana ; Williams, John ; Ferreira, Filipa ; Feher, Michael D. ; Ashworth, Andrew J. ; Joy, Mark P. ; de Lusignan, Simon ; Hobbs, F.D. Richard</creatorcontrib><description>Hypertension has been identified as a risk factor for coronavirus disease 2019 (COVID-19) and associated adverse outcomes. This study examined the association between preinfection blood pressure (BP) control and COVID-19 outcomes using data from 460 general practices in England. Eligible patients were adults with hypertension who were tested or diagnosed with COVID-19. BP control was defined by the most recent BP reading within 24 months of the index date (January 1, 2020). BP was defined as controlled (&lt;130/80 mm Hg), raised (130/80–139/89 mm Hg), stage 1 uncontrolled (140/90–159/99 mm Hg), or stage 2 uncontrolled (≥160/100 mm Hg). The primary outcome was death within 28 days of COVID-19 diagnosis. Secondary outcomes were COVID-19 diagnosis and COVID-19–related hospital admission. Multivariable logistic regression was used to examine the association between BP control and outcomes. Of the 45 418 patients (mean age, 67 years; 44.7% male) included, 11 950 (26.3%) had controlled BP. These patients were older, had more comorbidities, and had been diagnosed with hypertension for longer. A total of 4277 patients (9.4%) were diagnosed with COVID-19 and 877 died within 28 days. Individuals with stage 1 uncontrolled BP had lower odds of COVID-19 death (odds ratio, 0.76 [95% CI, 0.62–0.92]) compared with patients with well-controlled BP. There was no association between BP control and COVID-19 diagnosis or hospitalization. These findings suggest BP control may be associated with worse COVID-19 outcomes, possibly due to these patients having more advanced atherosclerosis and target organ damage. 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Richard</creatorcontrib><title>Association Between Blood Pressure Control and Coronavirus Disease 2019 Outcomes in 45 418 Symptomatic Patients With Hypertension: An Observational Cohort Study</title><title>Hypertension (Dallas, Tex. 1979)</title><addtitle>Hypertension</addtitle><description>Hypertension has been identified as a risk factor for coronavirus disease 2019 (COVID-19) and associated adverse outcomes. This study examined the association between preinfection blood pressure (BP) control and COVID-19 outcomes using data from 460 general practices in England. Eligible patients were adults with hypertension who were tested or diagnosed with COVID-19. BP control was defined by the most recent BP reading within 24 months of the index date (January 1, 2020). BP was defined as controlled (&lt;130/80 mm Hg), raised (130/80–139/89 mm Hg), stage 1 uncontrolled (140/90–159/99 mm Hg), or stage 2 uncontrolled (≥160/100 mm Hg). The primary outcome was death within 28 days of COVID-19 diagnosis. Secondary outcomes were COVID-19 diagnosis and COVID-19–related hospital admission. Multivariable logistic regression was used to examine the association between BP control and outcomes. Of the 45 418 patients (mean age, 67 years; 44.7% male) included, 11 950 (26.3%) had controlled BP. These patients were older, had more comorbidities, and had been diagnosed with hypertension for longer. A total of 4277 patients (9.4%) were diagnosed with COVID-19 and 877 died within 28 days. Individuals with stage 1 uncontrolled BP had lower odds of COVID-19 death (odds ratio, 0.76 [95% CI, 0.62–0.92]) compared with patients with well-controlled BP. There was no association between BP control and COVID-19 diagnosis or hospitalization. These findings suggest BP control may be associated with worse COVID-19 outcomes, possibly due to these patients having more advanced atherosclerosis and target organ damage. 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BP control was defined by the most recent BP reading within 24 months of the index date (January 1, 2020). BP was defined as controlled (&lt;130/80 mm Hg), raised (130/80–139/89 mm Hg), stage 1 uncontrolled (140/90–159/99 mm Hg), or stage 2 uncontrolled (≥160/100 mm Hg). The primary outcome was death within 28 days of COVID-19 diagnosis. Secondary outcomes were COVID-19 diagnosis and COVID-19–related hospital admission. Multivariable logistic regression was used to examine the association between BP control and outcomes. Of the 45 418 patients (mean age, 67 years; 44.7% male) included, 11 950 (26.3%) had controlled BP. These patients were older, had more comorbidities, and had been diagnosed with hypertension for longer. A total of 4277 patients (9.4%) were diagnosed with COVID-19 and 877 died within 28 days. Individuals with stage 1 uncontrolled BP had lower odds of COVID-19 death (odds ratio, 0.76 [95% CI, 0.62–0.92]) compared with patients with well-controlled BP. There was no association between BP control and COVID-19 diagnosis or hospitalization. These findings suggest BP control may be associated with worse COVID-19 outcomes, possibly due to these patients having more advanced atherosclerosis and target organ damage. 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source MEDLINE; American Heart Association Journals; EZB-FREE-00999 freely available EZB journals
subjects Adult
Aged
Aged, 80 and over
Antihypertensive Agents - therapeutic use
Atherosclerosis - epidemiology
Blood Pressure - drug effects
Comorbidity
COVID-19 - epidemiology
COVID-19 - prevention & control
England - epidemiology
Ethnicity - statistics & numerical data
Female
Follow-Up Studies
Hospitalization - statistics & numerical data
Humans
Hypertension - drug therapy
Hypertension - epidemiology
Logistic Models
Male
Middle Aged
Odds Ratio
Original
Pandemics
Primary Health Care - statistics & numerical data
Retrospective Studies
Risk Factors
SARS-CoV-2
Severity of Illness Index
Survival Analysis
Treatment Outcome
title Association Between Blood Pressure Control and Coronavirus Disease 2019 Outcomes in 45 418 Symptomatic Patients With Hypertension: An Observational Cohort Study
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