The 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 COVID-19 and associated adverse outcomes. This study examined the association between pre-infection blood pressure (BP) control and COVID-19 outcomes using data from 460 general practices in England. Eligible patients were adults with hypertensio...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
American Heart Association
2020
|
| _version_ | 1826289467395145728 |
|---|---|
| author | Sheppard, JP Nicholson, B Lee, J McGagh, D Sherlock, J Koshiaris, C Oke, J Jones, NR Hinton, W Armitage, L Van Hecke, O Lay-Flurrie, SL Bankhead, CR Liyanage, H Williams, J Ferreira, F Feher, MD Ashworth, AJ Joy, M de Lusignan, S Hobbs, FDR |
| author_facet | Sheppard, JP Nicholson, B Lee, J McGagh, D Sherlock, J Koshiaris, C Oke, J Jones, NR Hinton, W Armitage, L Van Hecke, O Lay-Flurrie, SL Bankhead, CR Liyanage, H Williams, J Ferreira, F Feher, MD Ashworth, AJ Joy, M de Lusignan, S Hobbs, FDR |
| author_sort | Sheppard, JP |
| collection | OXFORD |
| description | Hypertension has been identified as a risk factor for COVID-19 and associated adverse outcomes. This study examined the association between pre-infection 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 reading within 24months of the index date (01/01/2020). BP was defined as controlled (<130/80mmHg), raised (130/80-139/89mmHg), stage 1 uncontrolled (140/90-159/99mmHg) or stage 2 uncontrolled ({greater than or equal to}160/100mmHg). 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 co-morbidities and had been diagnosed with hypertension for longer. A total of 4,277 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 (OR 0.76, 95%CI 0.62-0.92) compared to patients with well-controlled BP. There was no association between BP control and COVID-19 diagnosis or hospitalisation. 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. Such patients may need to consider adhering to stricter social-distancing, to limit the impact of COVID-19 as future waves of the pandemic occur.
|
| first_indexed | 2024-03-07T02:29:19Z |
| format | Journal article |
| id | oxford-uuid:a6b21976-31cf-457f-96ac-b29c0b217bb1 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T02:29:19Z |
| publishDate | 2020 |
| publisher | American Heart Association |
| record_format | dspace |
| spelling | oxford-uuid:a6b21976-31cf-457f-96ac-b29c0b217bb12022-03-27T02:49:10ZThe association between blood pressure control and Coronavirus Disease 2019 outcomes in 45,418 symptomatic patients with hypertension: An observational cohort studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:a6b21976-31cf-457f-96ac-b29c0b217bb1EnglishSymplectic Elements American Heart Association2020Sheppard, JPNicholson, BLee, JMcGagh, DSherlock, JKoshiaris, COke, JJones, NRHinton, WArmitage, LVan Hecke, OLay-Flurrie, SLBankhead, CRLiyanage, HWilliams, JFerreira, FFeher, MDAshworth, AJJoy, Mde Lusignan, SHobbs, FDRHypertension has been identified as a risk factor for COVID-19 and associated adverse outcomes. This study examined the association between pre-infection 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 reading within 24months of the index date (01/01/2020). BP was defined as controlled (<130/80mmHg), raised (130/80-139/89mmHg), stage 1 uncontrolled (140/90-159/99mmHg) or stage 2 uncontrolled ({greater than or equal to}160/100mmHg). 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 co-morbidities and had been diagnosed with hypertension for longer. A total of 4,277 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 (OR 0.76, 95%CI 0.62-0.92) compared to patients with well-controlled BP. There was no association between BP control and COVID-19 diagnosis or hospitalisation. 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. Such patients may need to consider adhering to stricter social-distancing, to limit the impact of COVID-19 as future waves of the pandemic occur. |
| spellingShingle | Sheppard, JP Nicholson, B Lee, J McGagh, D Sherlock, J Koshiaris, C Oke, J Jones, NR Hinton, W Armitage, L Van Hecke, O Lay-Flurrie, SL Bankhead, CR Liyanage, H Williams, J Ferreira, F Feher, MD Ashworth, AJ Joy, M de Lusignan, S Hobbs, FDR The association between blood pressure control and Coronavirus Disease 2019 outcomes in 45,418 symptomatic patients with hypertension: An observational cohort study |
| title | The association between blood pressure control and Coronavirus Disease 2019 outcomes in 45,418 symptomatic patients with hypertension: An observational cohort study |
| title_full | The association between blood pressure control and Coronavirus Disease 2019 outcomes in 45,418 symptomatic patients with hypertension: An observational cohort study |
| title_fullStr | The association between blood pressure control and Coronavirus Disease 2019 outcomes in 45,418 symptomatic patients with hypertension: An observational cohort study |
| title_full_unstemmed | The association between blood pressure control and Coronavirus Disease 2019 outcomes in 45,418 symptomatic patients with hypertension: An observational cohort study |
| title_short | The association between blood pressure control and Coronavirus Disease 2019 outcomes in 45,418 symptomatic patients with hypertension: An observational cohort study |
| title_sort | association between blood pressure control and coronavirus disease 2019 outcomes in 45 418 symptomatic patients with hypertension an observational cohort study |
| work_keys_str_mv | AT sheppardjp theassociationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT nicholsonb theassociationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT leej theassociationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT mcgaghd theassociationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT sherlockj theassociationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT koshiarisc theassociationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT okej theassociationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT jonesnr theassociationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT hintonw theassociationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT armitagel theassociationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT vanheckeo theassociationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT layflurriesl theassociationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT bankheadcr theassociationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT liyanageh theassociationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT williamsj theassociationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT ferreiraf theassociationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT fehermd theassociationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT ashworthaj theassociationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT joym theassociationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT delusignans theassociationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT hobbsfdr theassociationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT sheppardjp associationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT nicholsonb associationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT leej associationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT mcgaghd associationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT sherlockj associationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT koshiarisc associationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT okej associationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT jonesnr associationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT hintonw associationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT armitagel associationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT vanheckeo associationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT layflurriesl associationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT bankheadcr associationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT liyanageh associationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT williamsj associationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT ferreiraf associationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT fehermd associationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT ashworthaj associationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT joym associationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT delusignans associationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy AT hobbsfdr associationbetweenbloodpressurecontrolandcoronavirusdisease2019outcomesin45418symptomaticpatientswithhypertensionanobservationalcohortstudy |