THE IMPACT OF THE COVID-19 PANDEMIC ON OFFICE AND 24-HOUR BLOOD PRESSURE PHENOTYPES (ESH ABPM COVID-19 STUDY)

Objective: The COVID-19 pandemic had a huge impact on access to healthcare and on the presence of follow-up visits in ambulatory care. This study evaluated the influence of the COVID-19 pandemic on blood pressure (BP) control and phenotypes as assessed by office and 24-hour ambulatory BP monitoring (ABPM). Design and method: Clinical and BP data were collected from 33 centers including Excellence Centers of the European Society of Hypertension. Two groups of patients with treated hypertension were compared. Group1 (pandemic): including participants who had ABPM twice - at visit 2 during the COVID-19 pandemic and visit 1 performed 9-15 months prior to visit 2. Group2 (pre-pandemic): had ABPM in two visits, performed before the pandemic within 9-15 months interval. In the current analysis we determined BP phenotypes among all patients. The following phenotypes were distinguished: masked uncontrolled hypertension (MUCH), white coat uncontrolled hypertension (WUCH), sustained controlled hypertension (SCH) and sustained uncontrolled hypertension (SUCH), according to ESH 2023 Guidelines. We analyzed whether these phenotypes changed between visits. Results: Of overall 1620 patients included in the study, we excluded those with missing ABPM or clinical data precluding to define BP phenotypes. Patients with uncontrolled hypertension on both visits and patients switching between MUCH and WUCH were also excluded. Finally, data of 983 patients, 423 (43%) in the pandemic group and 560 (57%) in the pre-pandemic group were analyzed. At baseline (visit 1), BP phenotypes prevalence did not differ between groups. In the pandemic group, the prevalence of SUCH increased during follow up (9% vs 20.8%, p<0.001), while the prevalence of SCH remained unchanged between visits (43.7% vs 46.3%, p=0.45). In contrast, in the pre-pandemic group, the prevalence of the SCH increased during follow-up (41.3% vs 55%, p <0.001). On visit 2 in the pandemic group, the prevalence of SCH was lower than in the pre-pandemic group (46.3% vs 55%, p=0.007). In multivariable adjusted analysis, the only significant factor influencing the negative changes of BP phenotypes was the COVID-19 pandemic period. Conclusions: These results indicate a negative impact of the COVID-19 pandemic on BP control assessed by BP phenotypes.