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Disruption in Blood Pressure Control With the COVID-19 Pandemic: The PCORnet Blood Pressure Control Laboratory
Journal article   Open access   Peer reviewed

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

Alanna M. Chamberlain, Elizabeth A. Chrischilles, Rhonda M. Cooper-DeHoff, Valy Fontil, Ester Kim Nilles, Kathryn M. Shaw, Myra Smith, Feng Lin, Eric Vittinghoff, Carlos Maeztu, …
Mayo Clinic proceedings, Vol.98(5), pp.662-675
05/2023
DOI: 10.1016/j.mayocp.2022.12.024
PMCID: PMC9874044
PMID: 37137641
url
https://doi.org/10.1016/j.mayocp.2022.12.024View
Published (Version of record) Open Access

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 National Patient-Centered Clinical Research Network (PCORnet) Blood Pressure Control Laboratory Surveillance System responded to data queries, producing 9 BP control metrics. Averages of the BP control metrics (weighted by numbers of observations in each health system) were calculated and compared between two 1-year measurement periods (January 1, 2019, through December 31, 2019, and January 1, 2020, through December 31, 2020). Results Among 1,770,547 hypertensive persons in 2019, BP control to <140/<90 mm Hg varied across 24 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 mm Hg (29.9% in 2019 and 25.4% in 2020) and improvement in BP (reduction of 10 mm Hg in systolic BP or achievement of systolic BP <140 mm Hg; 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.
Electronic Health Records Hypertension ACC AHA, American College of Cardiology American Heart Association blood pressure BP, blood pressure BRFSS, behavioral risk factor surveillance system CCB, calcium channel blockers COVID-19 DBP, diastolic blood pressure Original SBP, systolic blood pressure surveillance

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