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Disruption in Blood Pressure Control With the COVID-19 Pandemic: The PCORnet Blood Pressure Control Laboratory

Published:January 25, 2023DOI:https://doi.org/10.1016/j.mayocp.2022.12.024
Disruption in Blood Pressure Control With the COVID-19 Pandemic: The PCORnet Blood Pressure Control Laboratory
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      Abstract

      Objective

      To explore trends in blood pressure (BP) control before and during the COVID-19 pandemic.

      Patients and Methods

      Health systems participating in the PCORnet® Blood Pressure Control Laboratory Surveillance System responded to data queries producing nine BP control metrics. Averages of the BP control metrics (weighted by numbers of observations in each health system) were calculated and compared between 2 one-year measurement periods (1/1/2019-12/31/2019 and 1/1/2020-12/31/2020).

      Results

      Among 24 health systems with 1,770,547 hypertensive persons in 2019, BP control to <140/<90 mmHg varied across health systems (range: 46%-74%). Reduced BP control occurred in most health systems with onset of the COVID-19 pandemic; the weighted average BP control was 60.5% in 2019 and 53.3% in 2020. Reductions were also evident for BP control to <130/<80 mmHg (29.9% in 2019 and 25.4% in 2020) and improvement in BP (reduction of 10 mmHg in systolic BP or achievement of systolic BP <140 mmHg; 29.7% in 2019 and 23.8% in 2020). Two BP control process metrics exhibited pandemic-associated disruption: repeat visit in 4 weeks after a visit with uncontrolled hypertension (36.7% in 2019 and 31.7% in 2020) and prescription of fixed dose combination medications among those with 2 or more drug classes (24.6% in 2019 and 21.5% in 2020).

      Conclusion

      BP control decreased substantially during the COVID-19 pandemic, with a corresponding reduction in follow-up health care visits among persons with uncontrolled hypertension. It is unclear whether the observed decline in BP control during the pandemic will contribute to future cardiovascular events.

      Keywords

      Abbreviations:

      ACC/AHA (American College of Cardiology/American Heart Association), BP (blood pressure), BRFSS (behavioral risk factor surveillance system), CCB (calcium channel blockers), DBP (diastolic blood pressure), SBP (systolic blood pressure)

      Article info

      Publication history

      Accepted: December 19, 2022
      Received in revised form: December 16, 2022
      Received: September 2, 2022

      Publication stage

      In Press Accepted Manuscript

      Footnotes

      Disclosures

      Drs. Wozniak and Rakotz are employees of the American Medical Association, and Dr. Sanchez is an employee of the American Heart Association. The PCORI funding partially supported salaries (A. Chamberlain, R. Cooper-DeHoff, V. Fontil, K. Shaw, M. Smith, J. Todd, T. Carton, E. O’Brien, M. Faulkner Modrow, M. Pletcher) or consulting income (C. Maeztu).

      Credit Statement

      Author Contributions

      Alanna M. Chamberlain, Rhonda M. Cooper-DeHoff, Ester Kim Nilles, Kathryn M. Shaw, Myra Smith, Feng Lin, Eric Vittinghoff, Mark J. Pletcher. Substantial contributions to conception or design of the work, or the acquisition, analysis, or interpretation of data for the work.

      Alanna M. Chamberlain, Rhonda M. Cooper-DeHoff, Feng Lin, Eric Vittinghoff, Mark J. Pletcher. Drafting of the work or revising it critically for important intellectual content.

      All Authors. Final approval of the version to be published.

      Alanna M. Chamberlain. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

      Identification

      DOI: https://doi.org/10.1016/j.mayocp.2022.12.024

      Copyright

      © 2023 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

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