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Clinical impact of blood pressure variability in patients with COVID-19 and hypertension #MMPMID33958526
Nam JH; Park JI; Kim BJ; Kim HT; Lee JH; Lee CH; Son JW; Kim U; Park JS; Shin DG; Hong KS; Jang JG; Ahn JH; Jin HJ; Choi EY; Shin KC; Chung JH; Lee KH; Hur J; Hong YH; Lee CK
Blood Press Monit 2021[Oct]; 26 (5): 348-356 PMID33958526show ga
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.
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Blood+Press+Monit 2021 ; 26 (5): 348-356
