Long-term effects of SARS-CoV-2 infection on blood vessels and blood pressure – LOCHINVAR
Lip, Stefanie; Tran, Tran Q.B.; Hanna, Rebecca; Nichol, Sarah; Guzik, Tomasz J.; Delles, Christian; McClure, John; McCallum, Linsay; Touyz, Rhian M.; Berry, Colin; Padmanabhan, Sandosh
OBJECTIVE
The COVID-19 pandemic has been linked to endothelial dysfunction and renin–angiotensin–aldosterone system (RAAS) dysregulation, potentially worsening hypertension. Longitudinal studies are needed to establish COVID-19's lasting effects on blood pressure (BP) and endothelial function. Our objective was to determine whether COVID-19 increases future hypertension risk by comparing BP and endothelial function in nonhypertensive COVID-19 survivors with nonhypertensive controls.
METHODS
This single-centre prospective longitudinal study included participants without hypertension history, with cases being hospital-admitted COVID-19 survivors and controls having negative SARS-CoV-2 antibody tests. Ambulatory blood pressure monitoring, flow-mediated dilatation (FMD), 6-min walk test (6MWT), and quality of life (QoL) assessments were conducted at baseline and 12 months. RAAS phenotyping was performed at baseline. Data analysis used paired t-tests and multivariable regression on full and per-protocol datasets.
RESULTS
The full (n = 97) and per-protocol (n = 66) datasets included 37 and 15 cases respectively. Median ages (IQR: interquartile range) were 49.0 (43.0–53.5) and 50.0 (42–54.0) years. Baseline RAAS parameters were similar. Multivariable adjusted analyses in the per-protocol group showed SARS-CoV-2 positive participants had a 12-month increase in mean systolic BP (4.57 mmHg, [95% CI –0.04 to 9.18], P = 0.052), diastolic BP (4.46 mmHg [1.01 to 7.90], P = 0.012), decrease in FMD (–3.15% [–6.33 to 0.04], P = 0.053) and improvement in 6MWT (145.6 m [49.1 to 242.1], P = 0.004) compared to controls. QoL assessments indicated continued challenges for recovered COVID-19 individuals at 12 months.
CONCLUSIONS
Persistent vascular dysfunction and BP increase post-COVID-19 underscore the need for further studies on the long-term risk of hypertension and cardiovascular disease.
CLINICAL TRIAL REGISTRATION
https://clinicaltrials.gov/study/NCT05087290
Link | PDF (Journal of Hypertension)
Lip, Stefanie; Tran, Tran Q.B.; Hanna, Rebecca; Nichol, Sarah; Guzik, Tomasz J.; Delles, Christian; McClure, John; McCallum, Linsay; Touyz, Rhian M.; Berry, Colin; Padmanabhan, Sandosh
OBJECTIVE
The COVID-19 pandemic has been linked to endothelial dysfunction and renin–angiotensin–aldosterone system (RAAS) dysregulation, potentially worsening hypertension. Longitudinal studies are needed to establish COVID-19's lasting effects on blood pressure (BP) and endothelial function. Our objective was to determine whether COVID-19 increases future hypertension risk by comparing BP and endothelial function in nonhypertensive COVID-19 survivors with nonhypertensive controls.
METHODS
This single-centre prospective longitudinal study included participants without hypertension history, with cases being hospital-admitted COVID-19 survivors and controls having negative SARS-CoV-2 antibody tests. Ambulatory blood pressure monitoring, flow-mediated dilatation (FMD), 6-min walk test (6MWT), and quality of life (QoL) assessments were conducted at baseline and 12 months. RAAS phenotyping was performed at baseline. Data analysis used paired t-tests and multivariable regression on full and per-protocol datasets.
RESULTS
The full (n = 97) and per-protocol (n = 66) datasets included 37 and 15 cases respectively. Median ages (IQR: interquartile range) were 49.0 (43.0–53.5) and 50.0 (42–54.0) years. Baseline RAAS parameters were similar. Multivariable adjusted analyses in the per-protocol group showed SARS-CoV-2 positive participants had a 12-month increase in mean systolic BP (4.57 mmHg, [95% CI –0.04 to 9.18], P = 0.052), diastolic BP (4.46 mmHg [1.01 to 7.90], P = 0.012), decrease in FMD (–3.15% [–6.33 to 0.04], P = 0.053) and improvement in 6MWT (145.6 m [49.1 to 242.1], P = 0.004) compared to controls. QoL assessments indicated continued challenges for recovered COVID-19 individuals at 12 months.
CONCLUSIONS
Persistent vascular dysfunction and BP increase post-COVID-19 underscore the need for further studies on the long-term risk of hypertension and cardiovascular disease.
CLINICAL TRIAL REGISTRATION
https://clinicaltrials.gov/study/NCT05087290
Link | PDF (Journal of Hypertension)
