Anxiety, home blood pressure monitoring, and cardiovascular events among older hypertension patients during the COVID-19 pandemic

Zhang，Shuyuan1; Zhong，Yixuan1; Wang，Lixin2; Yin，Xinhua3,4; Li，Yufeng5; Liu，Yunlan6; Dai，Qiuyan7; Tong，Anli8; Li，Dongfeng9; Zhang，Liangqing10; Li，Ping11; Zhang，Guohui12; Huang，Rongjie13; Liu，Jinguang14; Zhao，Luosha15; Yu，Jing16; Zhang，Xinjun17; Yang，Li18; Cai，Jun1; Zhang，Weili1

2022

10.1038/s41440-022-00852-0

HYPERTENSION RESEARCH   影响因子和分区

0916-9636

1348-4214

The global coronavirus disease 2019 (COVID-19) pandemic has led to a health crisis. It remains unclear how anxiety affects blood pressure (BP) and cardiovascular risk among older patients with hypertension. In this study, we extracted longitudinal data on home BP monitored via a smartphone-based application in 3724 elderly patients with hypertension from a clinical trial (60–80 years; 240 in Wuhan and 3484 in non-Wuhan areas) to examine changes in morning BP during the COVID-19 outbreak in China. Anxiety was evaluated using Generalized Anxiety Disorder-7 item scores. Changes in morning systolic BP (SBP) were analyzed for five 30-day periods during the pandemic (October 21, 2019 to March 21, 2020), including the pre-epidemic, incubation, developing, outbreak, and plateau periods. Data on cardiovascular events were prospectively collected for one year. A total of 262 individuals (7.0%) reported an increased level of anxiety, and 3462 individuals (93.0%) did not. Patients with anxiety showed higher morning SBP than patients without anxiety, and the between-group differences in SBP change were +1.2 mmHg and +1.7 mmHg during the outbreak and plateau periods (P < 0.05), respectively. The seasonal BP variation in winter among patients with anxiety was suppressed during the pandemic. Anxious patients had higher rates of uncontrolled BP. During the 1-year follow-up period, patients with anxiety had an increased risk of cardiovascular events with a hazard ratio of 2.47 (95% confidence interval, 1.10–5.58; P = 0.03). In summary, COVID-19-related anxiety was associated with a short-term increase in morning SBP among older patients and led to a greater risk of cardiovascular events. (ClinicalTrials. gov number, NCT03015311).

Anxiety Cardiovascular disease Coronavirus disease 2019 (COVID-19) Home blood pressure Smartphone-based application

SCI

英语

其他

WOS:000745388900001

CLINICAL MEDICINE

2-s2.0-85123356827

Scopus

1.State Key Laboratory of Cardiovascular Disease,Hypertension Center,FuWai Hospital,National Center for Cardiovascular Diseases,Peking Union Medical College & Chinese Academy of Medical Sciences,Beijing,Beilishi Road 167, Xicheng District,100037,China
2.The First Affiliated Hospital of Hebei North University,Hebei,075061,China
3.Southern University of Science and Technology Hospital,Shenzhen,518000,China
4.First Affiliated Hospital of Harbin Medical University,Heilongjiang,150081,China
5.Beijing Pinggu Hospital,Beijing,101200,China
6.The First Hospital of Kunming,Yunnan,650011,China
7.Shanghai General Hospital,Shanghai Jiaotong University,Shanghai,200080,China
8.Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College,Beijing,100730,China
9.Wuxiang County People’s Hospital,Shanxi,046300,China
10.Shanxi Cardiovascular Hospital,Shanxi,030000,China
11.2nd Affiliated Hospital of Nan Chang University,Jiangxi,330006,China
12.Zhenjiang First People’s Hospital,Jiangsu,212002,China
13.The First Affiliated Hospital of Guangxi Medical University,Guangxi,530021,China
14.Huizhou Municipal Central Hospital,Guangdong,516001,China
15.First Affiliated Hospital of Zhengzhou University,Henan,450000,China
16.Lanzhou University Second Hospital,Gansu,730030,China
17.West China Hospital,Sichuan University,Sichuan,610041,China
18.Yan’an Hospital affiliated Kunming Medical University,Yunnan,650101,China
19.

Zhang，Shuyuan,Zhong，Yixuan,Wang，Lixin,et al. Anxiety, home blood pressure monitoring, and cardiovascular events among older hypertension patients during the COVID-19 pandemic[J]. HYPERTENSION RESEARCH,2022.

Zhang，Shuyuan.,Zhong，Yixuan.,Wang，Lixin.,Yin，Xinhua.,Li，Yufeng.,...&Zhang，Weili.(2022).Anxiety, home blood pressure monitoring, and cardiovascular events among older hypertension patients during the COVID-19 pandemic.HYPERTENSION RESEARCH.

Zhang，Shuyuan,et al."Anxiety, home blood pressure monitoring, and cardiovascular events among older hypertension patients during the COVID-19 pandemic".HYPERTENSION RESEARCH (2022).