Table 1:
Studies examining the effects of public restrictive measures on BP levels and BP control during the COVID-19 pandemic based on different BP measurements.
| Author, year | Location | Study design | Participants | Main results |
|---|---|---|---|---|
| Office BP | ||||
| Laffin et al., 2021 [26] | USA | Longitudinal cohort study | 464 585 individuals participating in an annual employer-sponsored wellness program (2018–2020) | • ↑ monthly mean changes during the pandemic (SBP: from 1.10 to 2.50 mmHg and DBP: from 0.14 to 0.53 mmHg); larger increases in women, older participants (SBP) and younger participants (DBP)• During the pandemic, a larger proportion of participants were up-categorized than down-categorized according to 2017 AHA/ACC BP (26.8% versus 22.0%, P < .0001) |
| HBPM | ||||
| Shah et al., 2021 [27] | USA | Cohort study | 72 706 hypertensive patients | • ↑ mean monthly SBP (131.6 versus 127.5 mmHg, P < .001), DBP (80.2 versus 79.2 mmHg, P < .001) and MAP (97.4 versus 95.3 mmHg, P < .001) during pandemic compared to pre-pandemic period• ↑ participants with uncontrolled hypertension during the pandemic (19% versus 15%) |
| Zhang et al., 2021 [22] | China | Longitudinal cohort study | 7394 hypertensive elderly patients (60–80 years old) [Wuhan (n = 283) compared with other provinces of China (n = 7111)] | Patients in Wuhan versus non-Wuhan areas (five phases: pre-epidemic, incubation, developing, outbreak and plateau):• ↑ average morning SBP during incubation (134.7 versus 131.3 mmHg, P < .001), developing (135.1 versus 131.6 mmHg, P < .001) and outbreak phase (133.9 versus 130.8 mmHg, P < .001) and marginally higher during the plateau phase of the COVID-19 pandemic (131.2 versus 130.1 mmHg, P = .06)• ↑ differences in morning SBP (ΔSBP) from pre-epidemic levels during incubation (2.6 versus 0.1 mmHg, P < .001), developing (3.3 versus 0.4 mmHg, P < .001) and outbreak phase (1.7 versus −0.4 mmHg, P < .001) |
| Girerd et al., 2022 [30] | France | Retrospective cohort study | 2273 hypertensive patients | During lockdown ↓ SBP by 3 mmHg (95% CI −2.4 to −3.9) and DBP by 1.5 mmHg (95% CI −1.4 to −2.2) (all P < .001). In linear mixed effect models, only pre-lockdown BP levels but not age or sex had a significant effect on the SBP change; participants with higher SBP had a greater decrease in SBP during the lockdown |
| Pengo et al., 2022 [29] | Italy | Cohort study | 126 hypertensive patients | ↓ Average home SBP (123.23 versus 125.05 mmHg, P = .008) and DBP (74.45 versus 75.28 mmHg, P = .023) during lockdown compared with pre-lockdown period. Patients with uncontrolled HBP showed the most consistent decrease in SBP (130.00 versus 136.06 mmHg, P = 0.001) and DBP (78.78 versus 81.30 mmHg, P = .018) |
| Zhang et al. 2022 [23] | China | Longitudinal cohort study | 3724 hypertensive elderly patients (60–80 years old) (Wuhan n = 240) compared with other provinces of China (n = 3484) | Patients with anxiety versus patients without anxiety (five phases: pre-epidemic, incubation, developing, outbreak and plateau):• ↑ average morning SBP during incubation (132.7 versus 131.3 mmHg, P = .03), developing (132.8 versus 131.5 mmHg, P = .05), outbreak (132.9 versus 130.7 mmHg, P < .001) and plateau period of the COVID-19 pandemic (132.7 versus 130.0 mmHg, P < .001)• ↑ differences in morning SBP (ΔSBP) from pre-epidemic during outbreak (0.9 versus −0.3 mmHg, P = .01) and plateau phase (0.8 versus −0.9 mmHg, P < .001)• ↑ uncontrolled BP during the incubation (23.3% versus 20.4%, P = .02), developing (21.8% versus 20.8%, P = .02), outbreak (21.8% versus 18.5%, P = .01) and plateau period (29.8% versus 18.5%, P < .001)• ↑ higher risk of incident cardiovascular events during the 1-year follow-up period of the COVID-19 pandemic [HR 2.47 (95% CI 1.10–5.58), P = .03] |
| Office BP and HBPM | ||||
| Kobayashi et al, 2021 [22] | Japan | Retrospective cohort study | 748 patients (who visited regularly clinics for any lifestyle-related or chronic disease) | • ↑ office SBP (138.6 ± 18.6 versus 136.5 ± 17.5 mmHg, P < .001), DBP (79.0 ± 12.2 versus 78.2 ± 12.0 mmHg, P = .03) and MAP (98.9 ± 12.5 versus 97.6 ± 12.0 mmHg, P = .002) during the pandemic compared with the pre-pandemic• ↓ home SBP (126.9 ± 10.2 versus 128.2 ± 10.3 mmHg, P < .001), DBP (75.2 ± 9.0 versus 75.8 ± 8.8 mmHg, P = .01) and MAP (92.5 ± 8.1 versus 93.3 ± 7.9 mmHg, P = .001) during the pandemic compared with the pre-pandemic• ↑ white coat hypertension prevalence (17% versus 13%, P < .001) during the pandemic compared with the pre-pandemic |
| Feitosa et al., 2022 [28] | Brazil | Cohort study | 57 768 individuals (n = 24 227 untreated and n = 27 699 treated) | Main analysis (three periods: pre-pandemic era, early pandemic phase and late pandemic phase)• ↑ prevalence of high OBP and HBPM among untreated participants; ↓ prevalence of high OBP and HBPM among treated participants during the early pandemic period compared with pre-pandemicSubanalysis (495 untreated and 987 treated patients with available repeated measurements, same study periods)• No significant differences in rates of high BP before and during the two phases of the pandemic• No significant differences in BP levels, except for lower OBP and HBPM levels during the early pandemic period among treated participants (office SBP/DBP: 129 ± 18/80 ± 12 versus 134 ± 21/83 ± 12 mmHg, P < .01; home SBP/DBP 124 ± 15/77 ± 10 versus 127 ± 16/78 ± 11 mmHg, P < .05) |
| ABPM | ||||
| Celik et al., 2021 [24] | Turkey | Retrospective study | 142 patients with essential hypertension | • ↑ ambulatory BP during the pandemic (24-h SBP: 130.2 ± 6.4 versus 124.0 ± 5.6 mmHg, p<0.001; daytime SBP: 135.2 ± 6.9 versus 128.5 ± 5.2 mmHg, P < .001; nighttime SBP 120.4 ± 5.8 versus 116.0 ± 5.2 mmHg, P < .001). Similar results for 24-h, day- and nighttime DBP• ↑ ambulatory BP in patients with higher anxiety levels than those with low (24-h SBP: 134.0 ± 5.8 versus 128.0 ± 5.6, P < .001; daytime SBP: 139.0 ± 6.2 versus 132.0 ± 5.5, P < .001; nighttime SBP: 123.0 ± 5.4 versus 118.0 ± 5.4 mmHg, P < .001). Similar results for DBP |
| Emergency department | ||||
| Fosco et al., 2020 [28] | Argentina | Retrospective cohort study | 12 144 patients visited the Emergency Department | ↑ patients presenting to the emergency department with severe hypertension (BP ≥160/100 mmHg) (23.9% versus 15.5%, P < .001) |
HBPM, home BP monitoring; OBP, office BP.