COVID-19 Linked to Increased Risk of New-Onset Hypertension

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Patients with an episode of COVID-19, whether hospitalized or not, have an increased incidence of new-onset hypertension compared with patients with influenza, reports a study in Hypertension.

The retrospective study included 45,398 patients diagnosed with COVID-19 in a health system in the Bronx, NY, from March 2020 to August 2022. Of these, 28,576 had no history of hypertension, and approximately 20% of patients were hospitalized, and 80% were not. Six-month follow-up data were available for 1455 hospitalized and 5565 non-hospitalized patients.

At follow-up, persistent hypertension had developed in 20.6% of hospitalized and 10.9% of non-hospitalized patients with COVID-19. In a comparison sample of patients with influenza, rates of persistent hypertension were 16.3% for hospitalized and 4.4% for non-hospitalized patients. On adjusted analysis, odds ratios for persistent hypertension were 2.23 in hospitalized and 1.52 in non-hospitalized patients with COVID-19, relative to those with influenza.

In a model, including both hospitalized and non-hospitalized patients with COVID-19, the most significant risk factors for persistent hypertension were age, Black race, chronic kidney disease, chronic obstructive pulmonary disease, and coronary artery disease. A model comprising these factors was 80.20% accurate in predicting new-onset, persistent hypertension, with an area under the curve of 71.96%. Sensitivity analyses showed similar patterns.

New-onset, persistent hypertension may develop after COVID-19 in approximately 21% of hospitalized and 11% of non-hospitalized patients. These rates are substantially higher compared with patients with influenza in the same health system.

“These findings should heighten awareness to screen for hypertension following COVID-19 illness in at-risk patients,” the researchers conclude. They discuss possible mechanisms of the association between COVID-19 and hypertension [Zhang V, et al. Incidence of new-onset hypertension post-COVID-19: Comparison with influenza. Hypertension 2023; 80:2135–2148. doi: 10.1161/HYPERTENSIONAHA.123.21174].