ABSTRACT
We assessed blood pressure (BP) changes during fiscal years (April to March of the following year) 2015-2020 to clarify the effect of the state of emergency due to the coronavirus disease 2019 (COVID-19) pandemic in 2020. We then considered BP in 2019 separately, as the Japanese hypertension guidelines were updated in 2019. The present retrospective cohort study extracted data from 157,510 Japanese individuals aged <75 years (mean age: 50.3 years, men: 67.5%) from the annual health check-up data of the DeSC database. The trends in BP were assessed using a repeated measures linear mixed model. After adjusting for the month of health check-ups to exclude seasonal BP variation, systolic BP linearly increased during fiscal years 2015-2018. From the value estimated by the trend in 2015-2018, systolic BP was lower by ≤1 mmHg in fiscal year 2019 among the treated participants. Meanwhile, systolic/diastolic BP (95% confidence interval) increased by 2.11 (1.97-2.24)/1.05 (0.96-1.14) mmHg for untreated women (n = 43,292), 1.60 (1.51-1.70)/1.17 (1.11-1.24) mmHg for untreated men (n = 88,479), 1.92 (1.60-2.23)/0.46 (0.25-0.67) mmHg for treated women (n = 7855), and 1.00 (0.79-1.21)/0.39 (0.25-0.53) mmHg for treated men (n = 17,884) in fiscal year 2020. These increases remained time-dependent covariates after adjustments for age, body mass index, alcohol consumption, smoking, physical activity, and blood sampling indices. Social change due to the pandemic might have increased BP by approximately 1-2/0.5-1 mmHg. Meanwhile, only a slight decrease in BP was observed immediately after the guideline update in Japan.
Subject(s)
COVID-19 , Hypertension , Blood Pressure/physiology , Female , Humans , Japan/epidemiology , Male , Middle Aged , Pandemics , Retrospective StudiesABSTRACT
Non-communicable diseases (NCDs) are a global challenge, accounting for 71% of all deaths worldwide. The spread of coronavirus disease 2019 (COVID-19) and past huge disasters have affected the prevention and treatment of NCDs and require urgent action. In this narrative review, I will discuss several reports on the risk of NCDs during past disasters and propose possible future directions. Hypertension, the most common NCD, carries a high risk of death due to cerebrovascular, renal, and other complications. Effective use of information and communication technology-based telemedicine is necessary to manage the risk of cardiovascular diseases during disasters and pandemics. We observed the cumulative incidence of metabolic syndrome in subjects from tsunami-affected areas. We found that moving into prefabricated temporary housing was a risk factor for a higher incidence of metabolic syndrome in elderly females. Our follow-up of 1,009 subjects showed a slight, but significant, increase in HbA1c values after a state of emergency was introduced, even though the lockdown was not as stringent as in other countries. In a study elucidating the prevalence of wheezing and eczema symptoms and the associated factors after the Great East Japan Earthquake, psychological effects, such as depression and self-reported posttraumatic stress disorder, were observed, particularly in people with allergic diseases. In recent years, new birth cohort studies have been initiated to complement the studies designed to collect information across multiple generations, such as the Lifelines study in the Netherlands and the Avon Longitudinal Study of Parents and Children (ALSPAC) study in the UK. It is desirable to assess the effects of COVID-19 to complement the existing cohort studies in Japan as well.
ABSTRACT
AIMS: Some studies have reported changes in glycemic control of patients with diabetes mellitus under lockdown. However, no previous study examined the impact of the pandemic on glycemic control in patients with diabetes in countries that did not introduce a lockdown such as Japan. This study aimed to assess changes in glycemic control during the pandemic in patients with type 2 diabetes treated at a Japanese clinic. METHODS: We conducted a historical cohort study, using electronic medical records of patients with type 2 diabetes who visited our clinic between January 2019 and August 2020. Differences in HbA1c values before and after the outbreak of COVID-19 were the primary outcome, examined using the linear mixed model. RESULTS: HbA1c values significantly increased from 7.45% to 7.53% after the state of emergency was introduced (n = 1,009). Furthermore, a deterioration in HbA1c values was observed in particular among women, patients aged ≥ 65 years, those with body mass index of ≥ 25 kg/m2, and those that were not using insulin. CONCLUSIONS: Glycemic control deteriorated in patients with type 2 diabetes during the pandemic even in a country without a national lockdown.