Comparison of blood pressure monitoring from elderly community centres and at home under COVID-19 pandemic

ABSTRACT

Introduction: Under the COVID-19 pandemic, lockdown measures have been implemented in various countries in response to elevating number of confirmed COVID-19 cases. While there was only limited service from face-to-face community health program on BP management, home BP (HBP) monitoring was promoted. The current study aims to investigate (1) control of BP under the lockdown measures;(2) difference of BP from community health centre and home. Method(s) Participants enrolled in the program since July2020, with automated BP measurement from elderly community centres collected as centre BP. In response to COVID-19 outbreak in November2020 in Hong Kong, service from health program was limited and HBP measurement was promoted since December2020 (pre-section July-December2020). Service from community health centre was resumed in February2021. One-month runin period was allowed. Subjects were followed up until December2021 (post-section March-December2021) BP was compared on (1) centre BP between pre- and post-section, and (2) centre BP and HBP during post-section. Result(s) A total of 414 subjects were included in the study, with a mean age of 71.0. Three hundred and eight of them (74.4%) were reported with hypertension diagnosis. Mean centre BP was 135/73 for pre-section and 131/71 for post-section, while mean HBP was 123/70. Centre BP was significantly lower at post-section compared to pre-section, while HBP was significantly lower than centre BP during the post-section. The differences remained consistent regardless of hypertension status. Conclusion(s) There was no worsening of BP management during the COVID-19 outbreak. Despite long term use of automated BP measurement at elderly community centres, white coat effect persisted as demonstrated by difference between centre BP and HBP. HBP shall be preferred for BP management.