THE IMPACT OF COVID-19 PANDEMIC ON BLOOD PRESSURE CONTROL IN PATIENTS WITH TREATED HYPERTENSION. RESULTS OF EUROPEAN SOCIETY OF HYPERTENSION STUDY (ESH ABPM COVID-19 STUDY)

Objective: We aimed to assess the impact of the COVID-19 pandemic on blood pressure (BP) control assessed by office and ambulatory blood pressure monitoring (ABPM) in patients with treated hypertension. Design and method: Clinical and BP data were collected from 32 centres including Excellence Centres of the European Society of Hypertension. Two groups of patients were compared. Group1 (‘pandemic’) consisting of participants who have undergone two ABPM recordings (visits): visit-2 during the COVID-19 pandemic, and visit-1 performed 9 - 15 months prior to visit-2. Participants in Group2 (‘pre-pandemic’) had two repeated ABPMs, both performed before the pandemic within 9 - 15 months interval between visits. Results: Overall, 3384 ABPMs were collected from 1692 patients (50.5% men). 759 patients constituted Group1 and 933 patients Group2. Study groups did not differ regarding sex, age, or body weight. The duration of hypertension and frequency of first-line antihypertensive drug use at visit-1 were also similar in both groups. Beta-blockers were the only class of drugs with a significant decrease between visits (difference between visit-2 and visit-1) in Group1. At visit-1, there were no differences in all BP phenotypes (office and ABPM values) or hypertension control rates (27% vs 26.6%; p = 0.62) between study groups. At visit-2 significantly higher office BP was observed in Group1 compared to Group2, with a mean difference of +2.09 mmHg (p = 0.028) and +1.39 mmHg (p = 0.026) for systolic (SBP) and diastolic (DBP) BP, respectively. Moreover, on visit-2, higher 24-hour daytime and nighttime SBP and DBP were observed in Group1 as compared to Group2. Of note, the prevalence of uncontrolled hypertension (when considering both office and ABPM) was also higher at visit-2 in Goup1 than in Group2 (25.8% vs 20.0%; p = 0.005). Both SBP and DBP, regardless of the measurement method, dropped between visit-1 to visit-2, but to a lesser extent in Group1. Thus, the magnitude of BP decrease between visits was smaller in Group1 (delta24SBP: -1.04 vs -3.2 mmHg; p < 0.001 and delta24DBP: -1.22 vs -1.93 mmHg; p = 0.038). Conclusions: The results of the study indicate a negative impact of the COVID-19 pandemic on BP control both in office and during ABPM.