tetano
Editor, Senior Moderator
Blood Press Monit
. 2021 May 6.
doi: 10.1097/MBP.0000000000000544. Online ahead of print.
Clinical impact of blood pressure variability in patients with COVID-19 and hypertension
Jong-Ho Nam[SUP] 1 [/SUP], Jong Il Park, Byung-Jun Kim, Hun-Tae Kim, Jung-Hee Lee, Chan-Hee Lee, Jang-Won Son, Ung Kim, Jong-Seon Park, Dong-Gu Shin, Kyung Soo Hong, Jong Geol Jang, June Hong Ahn, Hyun Jung Jin, Eun Young Choi, Kyeong-Cheol Shin, Jin Hong Chung, Kwan Ho Lee, Jian Hur, Young-Hoon Hong, Choong-Ki Lee
Affiliations
Abstract
Objective: This study aimed to investigate the relationship between blood pressure variability (BPV) and clinical outcomes in patients with coronavirus disease 2019 (COVID-19) and hypertension.
Methods: A total of 136 patients hospitalized with COVID-19 were enrolled in this study. Patients were grouped according to the presence of hypertension and BPV. Mean arterial pressure (MAP) measured at 8 a.m. and 8 p.m. was analyzed, and BPV was calculated as the coefficient of variation of MAP (MAPCV). High BPV was defined as MAPCV values above the median. We compared the age, level of C-reactive protein (CRP), creatine kinase-MB (CK-MB), N-terminal pro-B type natriuretic peptide (NT-proBNP), creatinine and in-hospital mortality and investigated the relationship among the groups.
Results: COVID-19 patients with hypertension were older (70 ? 12 vs. 53 ? 17 years; P < 0.001), had higher levels of CRP (9.4 ? 9.2 vs. 5.3 ? 8.2 mg/dL; P = 0.009), MAPCV (11.4 ? 4.8 vs. 8.9 ? 3.2; P = 0.002), and higher in-hospital mortality (19.6% vs. 5.9%; P = 0.013) than those without hypertension. There was a proportional relationship between BPV and age, levels of CRP, CK-MB, NT-proBNP, creatinine and in-hospital mortality (all, P < 0.05). In Cox regression analysis, advanced age [?80 years, hazard ratio (HR) 10.4, 95% confidence interval (CI) 2.264-47.772, P = 0.003] and higher MAPCV (HR 1.617, 95% CI, 1.281-2.040, P < 0.001) were significantly associated with in-hospital mortality.
Conclusion: High BPV in COVID-19 patients with hypertension is significantly associated with in-hospital mortality. Advanced age and systemic inflammation are proportional to high BPV. Additional attention is needed for COVID-19 patients with hypertension and high BPV.
. 2021 May 6.
doi: 10.1097/MBP.0000000000000544. Online ahead of print.
Clinical impact of blood pressure variability in patients with COVID-19 and hypertension
Jong-Ho Nam[SUP] 1 [/SUP], Jong Il Park, Byung-Jun Kim, Hun-Tae Kim, Jung-Hee Lee, Chan-Hee Lee, Jang-Won Son, Ung Kim, Jong-Seon Park, Dong-Gu Shin, Kyung Soo Hong, Jong Geol Jang, June Hong Ahn, Hyun Jung Jin, Eun Young Choi, Kyeong-Cheol Shin, Jin Hong Chung, Kwan Ho Lee, Jian Hur, Young-Hoon Hong, Choong-Ki Lee
Affiliations
- PMID: 33958526
- DOI: 10.1097/MBP.0000000000000544
Abstract
Objective: This study aimed to investigate the relationship between blood pressure variability (BPV) and clinical outcomes in patients with coronavirus disease 2019 (COVID-19) and hypertension.
Methods: A total of 136 patients hospitalized with COVID-19 were enrolled in this study. Patients were grouped according to the presence of hypertension and BPV. Mean arterial pressure (MAP) measured at 8 a.m. and 8 p.m. was analyzed, and BPV was calculated as the coefficient of variation of MAP (MAPCV). High BPV was defined as MAPCV values above the median. We compared the age, level of C-reactive protein (CRP), creatine kinase-MB (CK-MB), N-terminal pro-B type natriuretic peptide (NT-proBNP), creatinine and in-hospital mortality and investigated the relationship among the groups.
Results: COVID-19 patients with hypertension were older (70 ? 12 vs. 53 ? 17 years; P < 0.001), had higher levels of CRP (9.4 ? 9.2 vs. 5.3 ? 8.2 mg/dL; P = 0.009), MAPCV (11.4 ? 4.8 vs. 8.9 ? 3.2; P = 0.002), and higher in-hospital mortality (19.6% vs. 5.9%; P = 0.013) than those without hypertension. There was a proportional relationship between BPV and age, levels of CRP, CK-MB, NT-proBNP, creatinine and in-hospital mortality (all, P < 0.05). In Cox regression analysis, advanced age [?80 years, hazard ratio (HR) 10.4, 95% confidence interval (CI) 2.264-47.772, P = 0.003] and higher MAPCV (HR 1.617, 95% CI, 1.281-2.040, P < 0.001) were significantly associated with in-hospital mortality.
Conclusion: High BPV in COVID-19 patients with hypertension is significantly associated with in-hospital mortality. Advanced age and systemic inflammation are proportional to high BPV. Additional attention is needed for COVID-19 patients with hypertension and high BPV.