Blood Pressure Control Worsened among US Adults during Pandemic, Suggests New Study

Women and older adults had the highest increases in blood pressure levels during the pandemic, according to new research.

Blood pressure (BP) control worsened among US adults during the COVID-19 pandemic, particularly among women and older adults, according to new research published online today in the American Heart Association’s (AHA) journal Circulation.

“At the start of the pandemic, most people were not taking good care of themselves. Increases in blood pressure were likely related to changes in eating habits, increased alcohol consumption, less physical activity, decreased medication adherence, more emotional stress and poor sleep,” said lead study author Luke Laffin, MD, co-director, Center for Blood Pressure Disorders, Cleveland Clinic, Ohio, in an AHA press release. “And we know that even small rises in blood pressure increase one’s risk of stroke and other adverse cardiovascular disease events.”

To assess changes in BP levels before and during the pandemic, Laffin and colleagues analyzed data from an annual employer-sponsored wellness program, which included both employees and their spouses/partners.

The data included 464 585 participants (53.5% women, mean age=45.7 years) who had their BP levels measured by trained personnel between 2018 and 2020. Participants were categorized into 4 groups based on the current AHA BP guidelines: normal, elevated, stage 1 hypertension (HTN), and stage 2 HTN.

The annual BP changes for 2019 vs 2018, January to March 2020 vs 2019, and April to December 2020 vs 2019 were estimated and compared between pre-pandemic (January 2019–March 2020) and pandemic (April–December 2020) periods, according to the study.

Results

Between 2019 and January to March 2020, results showed that systolic and diastolic BP levels remained largely unchanged. In contrast, an increase in annual BP levels was found to be significantly higher during the pandemic (April-December 2020) than in 2019 (P<.0001 for systolic and diastolic BP).

During the pandemic, average increases in BP levels each month ranged from 1.10 to 2.50 mm Hg for systolic BP and 0.14 to 0.53 mm Hg for diastolic BP, according to the study results. Larger increases were seen in women for systolic and diastolic BP, in older adults for systolic BP, and in younger participants for diastolic BP (all P<.0001).

From April to December 2020, compared to before the pandemic, a greater proportion of participants were recategorized to a higher BP category (26.8%) than a lower category (22%), according to researchers.

“From a public health perspective, during a pandemic, getting vaccinated and wearing a mask are important. However, the results of our research reinforce the need to also be mindful of chronic health conditions such as the worsening of blood pressure,” said Laffin in the press release.

Laffin and colleagues plan to follow up on these results to determine if BP levels will continue to rise in the future.

Limitations to the study included the fact that the reason for the observed rise in BP was unclear, and the results may not be representative of all US adults who do not participate in an employee wellness program, noted authors.

“Continued surveillance of BP among US adults after the pandemic is needed to assess the permanence of the increases noted here. Public health interventions reinforcing the need to address chronic medical problems, even during a pandemic, remain crucial,” concluded authors.