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Blood pressure control and adverse outcomes of COVID-19 infection in patients with concomitant hypertension in Wuhan, China.
Ran, Jinjun; Song, Ying; Zhuang, Zian; Han, Lefei; Zhao, Shi; Cao, Peihua; Geng, Yan; Xu, Lin; Qin, Jing; He, Daihai; Wu, Fengfu; Yang, Lin.
  • Ran J; School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.
  • Song Y; School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • Zhuang Z; Department of Medical Affairs, Huoshenshan Hospital, Wuhan, China.
  • Han L; No. 923 Hospital of Joint Service Supporting Force, Nanning, China.
  • Zhao S; Department of Applied Mathematics, Hong Kong Polytechnic University, Hong Kong, China.
  • Cao P; School of Nursing, Hong Kong Polytechnic University, Hong Kong, China.
  • Geng Y; JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China.
  • Xu L; Clinical Research Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
  • Qin J; Department of Infectious Diseases, Huoshenshan Hospital, Wuhan, China.
  • He D; Department of Gastroenterology, No. 923 Hospital of Joint Service Supporting Force, Nanning, China.
  • Wu F; School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
  • Yang L; School of Nursing, Hong Kong Polytechnic University, Hong Kong, China.
Hypertens Res ; 43(11): 1267-1276, 2020 11.
Article in English | MEDLINE | ID: covidwho-733529
ABSTRACT
Hypertension is a common comorbidity in hospitalized patients with COVID-19 infection. This study aimed to estimate the risks of adverse events associated with in-hospital blood pressure (BP) control and the effects of angiotensin II receptor blocker (ARB) prescription in COVID-19 patients with concomitant hypertension. In this retrospective cohort study, the anonymized medical records of COVID-19 patients were retrieved from an acute field hospital in Wuhan, China. Clinical data, drug prescriptions, and laboratory investigations were collected for individual patients with diagnosed hypertension on admission. Cox proportional hazards models were used to estimate the risks of adverse outcomes associated with BP control during the hospital stay. Of 803 hypertensive patients, 67 (8.3%) were admitted to the ICU, 30 (3.7%) had respiratory failure, 26 (3.2%) had heart failure, and 35 (4.8%) died. After adjustment for confounders, the significant predictors of heart failure were average systolic blood pressure (SBP) (hazard ratio (HR) per 10 mmHg 1.89, 95% confidence interval (CI) 1.15, 3.13) and pulse pressure (HR per 10 mmHg 2.71, 95% CI 1.39, 5.29). The standard deviations of SBP and diastolic BP were independently associated with mortality and ICU admission. The risk estimates of poor BP control were comparable between patients receiving ARBs and those not receiving ARBs, with the only exception of a high risk of heart failure in the non-ARB group. Poor BP control was independently associated with higher risks of adverse outcomes of COVID-19. ARB drugs did not increase the risks of adverse events in hypertensive patients.
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Full text: Available Collection: International databases Database: MEDLINE Type: Article Main subject: Pneumonia, Viral / Coronavirus Infections / Betacoronavirus / Hypertension Subject: Pneumonia, Viral / Coronavirus Infections / Betacoronavirus / Hypertension Type of study: Observational study / Prognostic study / Risk factors Language: English Journal: Hypertens Res Clinical aspect: Etiology / Prediction / Prognosis / Therapy Year: 2020

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Full text: Available Collection: International databases Database: MEDLINE Type: Article Main subject: Pneumonia, Viral / Coronavirus Infections / Betacoronavirus / Hypertension Subject: Pneumonia, Viral / Coronavirus Infections / Betacoronavirus / Hypertension Type of study: Observational study / Prognostic study / Risk factors Language: English Journal: Hypertens Res Clinical aspect: Etiology / Prediction / Prognosis / Therapy Year: 2020