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Anxiety, home blood pressure monitoring, and cardiovascular events among older hypertension patients during the COVID-19 pandemic.

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机构： [1]State Key Laboratory of Cardiovascular Disease, Hypertension Center, FuWai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beilishi Road 167, Xicheng District, Beijing 100037, China [2]The First Affiliated Hospital of Hebei North University, Hebei 075061, China [3]Southern University of Science and Technology Hospital, Shenzhen 518000, China [4]First Affiliated Hospital of Harbin Medical University, Heilongjiang 150081, China [5]Beijing Pinggu Hospital, Beijing 101200, China [6]The First Hospital of Kunming, Yunnan 650011, China [7]Shanghai General Hospital, Shanghai Jiaotong University, Shanghai 200080, China [8]Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China [9]Wuxiang County People’s Hospital, Shanxi 046300, China [10]Shanxi Cardiovascular Hospital, Shanxi 030000, China [11]2nd Affiliated Hospital of Nan Chang University, Jiangxi 330006, China [12]Zhenjiang First People’s Hospital, Jiangsu 212002, China [13]The First Affiliated Hospital of Guangxi Medical University, Guangxi 530021, China [14]Huizhou Municipal Central Hospital, Guangdong 516001, China [15]First Affiliated Hospital of Zhengzhou University, Henan 450000, China [16]Lanzhou University Second Hospital, Gansu 730030, China [17]West China Hospital, Sichuan University, Sichuan 610041, China [18]Yan’an Hospital affiliated Kunming Medical University, Yunnan 650101, China

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The global coronavirus disease 2019 (COVID-19) pandemic has led to a health crisis. It remains unclear how anxiety affects blood pressure (BP) and cardiovascular risk among older patients with hypertension. In this study, we extracted longitudinal data on home BP monitored via a smartphone-based application in 3724 elderly patients with hypertension from a clinical trial (60-80 years; 240 in Wuhan and 3484 in non-Wuhan areas) to examine changes in morning BP during the COVID-19 outbreak in China. Anxiety was evaluated using Generalized Anxiety Disorder-7 item scores. Changes in morning systolic BP (SBP) were analyzed for five 30-day periods during the pandemic (October 21, 2019 to March 21, 2020), including the pre-epidemic, incubation, developing, outbreak, and plateau periods. Data on cardiovascular events were prospectively collected for one year. A total of 262 individuals (7.0%) reported an increased level of anxiety, and 3462 individuals (93.0%) did not. Patients with anxiety showed higher morning SBP than patients without anxiety, and the between-group differences in SBP change were +1.2 mmHg and +1.7 mmHg during the outbreak and plateau periods (P < 0.05), respectively. The seasonal BP variation in winter among patients with anxiety was suppressed during the pandemic. Anxious patients had higher rates of uncontrolled BP. During the 1-year follow-up period, patients with anxiety had an increased risk of cardiovascular events with a hazard ratio of 2.47 (95% confidence interval, 1.10-5.58; P = 0.03). In summary, COVID-19-related anxiety was associated with a short-term increase in morning SBP among older patients and led to a greater risk of cardiovascular events. (ClinicalTrials. gov number, NCT03015311).© 2022. The Author(s).

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大类 | 2 区医学

小类 | 3 区外周血管病

最新[2023]版：

大类 | 2 区医学

小类 | 3 区外周血管病

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第一作者机构： [1]State Key Laboratory of Cardiovascular Disease, Hypertension Center, FuWai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beilishi Road 167, Xicheng District, Beijing 100037, China

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