Blood pressure control disrupted during the pandemic

Blood pressure (BP) control was reduced during the COVID-19 pandemic and has not returned to pre-pandemic levels. A large-scale observational study, conducted by the Mayo Clinic, followed over 1.7 million patients with hypertension in pre-pandemic and pandemic years. Future studies are needed to investigate whether this disruption in BP control will lead to an increase in cardiovascular events.

Epidemiologist Dr Alanna Chamberlain (Mayo Clinic, MN, USA) and colleagues assessed the changes in BP control between pre-pandemic and pandemic periods [1]. Included in the analysis were 24 US health systems (18 academic). The extracted data was standardised to the PCORnet common data model. The study compared 3 qualitative measures of BP control and improvement, and 6 process metrics relevant to clinical management and treatment practice for BP control between 2019 (pre-pandemic year) and 2020 (pandemic year).

In 2019, 1.77 million patients with hypertension had a combined 8.30 million healthcare encounters. In 2020, a similar number of patients (1.73 million) was followed but fewer encounters (6.59 million) were reported. The percentage of hypertensive patients who demonstrated BP control (<140/<90 mmHg) at an ambulatory care visitation had dropped from 60.5% in 2019 to 53.3% in 2020, displaying a difference in weighted averages of 7.2%. A similar trend was observed in the <130/<80 mmHg category, featuring a 4.6% reduction in BP control.

Achieved improvements in BP control, defined as a systolic BP reduction of 10 mmHg or a systolic BP<140 mmHg, declined from 29.7% in 2019 to 23.8% in 2020. The number of repeat visits among patients with uncontrolled hypertension dropped from 36.7% in the pre-pandemic year to 31.7% in the pandemic year. The proportion of patients who was prescribed an intensification of medication remained stable. Dr Chamberlain mentioned that they observed a large variance in BP control metrics across health systems, suggesting an opportunity for improvement.

 

1. 
   
   1. Chamberlain AM, et al. Disruption in Blood Pressure Control with the COVID-19 Pandemic: A Study of 24 US Health Systems in the PCORnet Blood Pressure Control Laboratory. LBS02, AHA Scientific Sessions 2021, 13–15 November.

 

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Posted on 14 January, 2022