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Buenos Aires, Argentina, November 19, 2020: The blockade due to the COVID-19 pandemic is associated with an increase in high blood pressure among patients admitted to the emergency. This is the result of a study presented at the 46th Argentine Congress of Cardiology (SAC).
SAC 2020 is a virtual meeting from 19th to 21st November. European Society of Cardiology (ESC) lecturers will participate in joint scientific sessions with the Argentina Society of Cardiology as part of the ESC Global Activities program.
“Admission to the emergency room during the mandatory period of social isolation has been linked to a 37% increase in the odds of having high blood pressure, even taking into account age, sex, month, day and time of the consultation and whether the patient arrived by ambulance, “said study author Dr. Matías Fosco of the University Hospital of the Favaloro Foundation, Buenos Aires.
Compulsory social isolation due to COVID-19 was implemented on March 20 in Argentina as part of a general lockdown. People were told to stay at home, except for essential workers (e.g. doctors and nurses). The general public could only leave the house to buy food, medicine and cleaning products. Schools and universities have been closed and public events have been suspended.
“After the onset of social isolation, we observed that more patients who came to the emergency had high blood pressure,” said Dr. Fosco. “We conducted this study to confirm or reject this impression.”
The study was conducted in the emergency room of the Favaloro University Hospital Foundation. The frequency of hypertension1 among patients 21 years of age and older during the three months of social isolation (March 20 to June 25, 2020) was compared with two previous time periods: the same three months in 2019 (from 21 March to 27 June 2019) and the three months immediately preceding social isolation (from 13 December 2019 to 19 March 2020).
Blood pressure is a standard measure upon admission to the emergency room, and nearly all patients (98.2%) admitted between March 21, 2019 and June 25, 2020 were included in the study. The most common reasons for hospitalization were chest pain, shortness of breath, dizziness, abdominal pain, fever, cough, and hypertension.
The study included 12,241 patients. The mean age was 57, and 45.6% were women. During the three-month isolation period, 1,643 patients were admitted to the emergency room. This was 56.9% less than in the same three months in 2019 (3,810 patients) and 53.9% less than in the three months immediately preceding social isolation (3,563 patients).
During the period of social isolation, 391 (23.8%) hospitalized emergency patients had high blood pressure. This percentage was significantly higher than in the same period in 2019, when it was 17.5%, and compared to the three months before social isolation, when it was 15.4% (p <0.01).
Dr Fosco said: “There are several possible reasons for the link between social isolation and hypertension. For example, increased stress due to the pandemic, with limited personal contact and the onset or exacerbation of financial or family difficulties. Modified behaviors may have played a role, with increased food and alcohol intake, sedentary lifestyles and weight gain. “
Dr. Fosco noted that the reasons for hospitalization were similar between the periods studied, so they were not responsible for the increase in high blood pressure. But he said: “Patients may have felt more psychological strain while being transported to hospital due to travel restrictions and police checks and fear of contracting the coronavirus after leaving home. Additionally, patients being treated for hypertension may have stopped taking the medicine due to preliminary warnings about possible adverse effects on COVID-19 outcomes (which were subsequently fired). “
He concluded: “Controlling blood pressure helps prevent heart attacks and strokes and severe COVID-19 illnesses, so maintaining healthy habits, even in conditions of social isolation and blockade, is essential. Many pandemic-related regulations have now loosen and we are investigating whether this affects the blood pressure of emergency patients. “
Dr Héctor Deschle, president of the scientific program of the SAC 2020, said: “This study illustrates the collateral damage generated by isolation. There has been a significant decrease in visits for heart disease, which inevitably leads to avoidable complications. But I would like to underline the psychological damage reported by the authors, which we perceive daily in consultations and which is expressed as fear, despair, irritability and difficulty in concentration. This affects interpersonal relationships and physical health. This study puts the spotlight on the concomitant consequences of the epidemic and the restrictions used to combat it. “
Professor Jose Luis Zamorano, ESC Regional Ambassador for Argentina at SAC 2020, said: “This very interesting study simply highlights that we cardiologists need to keep an eye on our cardiology patients beyond the pandemic. If we don’t treat and follow our heart patients carefully during the pandemic, we will see an increase in adverse outcomes in the future. “
Financing: none.
Disclosures: none.
References and Notes
1 High blood pressure was defined as systolic> 160 mmHg and / or diastolic> 100 mmHg, which is equivalent to grade 2 (moderate) or 3 (severe) hypertension according to the guidelines of the Argentine Society of Cardiology and the Society European Cardiology.
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