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. 2023 May;98(5):662-675.
doi: 10.1016/j.mayocp.2022.12.024. Epub 2023 Jan 25.

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

Alanna M Chamberlain  1 , Rhonda M Cooper-DeHoff  2 , Valy Fontil  3 , Ester Kim Nilles  4 , Kathryn M Shaw  5 , Myra Smith  5 , Feng Lin  6 , Eric Vittinghoff  6 , Carlos Maeztu  7 , Jonathan V Todd  8 , Thomas Carton  9 , Emily C O'Brien  4 , Madelaine Faulkner Modrow  6 , Gregory Wozniak  10 , Michael Rakotz  10 , Eduardo Sanchez  11 , Steven M Smith  12 , Tamar S Polonsky  13 , Faraz S Ahmad  14 , Mei Liu  15 , James C McClay  16 , Jeffrey J VanWormer  17 , Bradley W Taylor  18 , Elizabeth A Chrischilles  19 , Shenghui Wu  20 , Anthony J Viera  21 , Daniel E Ford  22 , Wenke Hwang  23 , Kirk U Knowlton  24 , Mark J Pletcher  6
Affiliations

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

Alanna M Chamberlain et al. Mayo Clin Proc. 2023 May.

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.

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Conflict of interest statement

Mr Maeztu receives consulting fees and support for attending meetings and/or travel from and participates in a data safety monitoring board or advisory board for the University of California at San Francisco and is a Citizen Scientist for the University of Florida. Drs Wozniak and Rakotz are employees of the American Medical Association. Dr Sanchez is an employee of the American Heart Association and has received funding from the Department of Health and Human Services. Dr S Smith has received funding from the National Heart, Lung and Blood Institute, Patient-Centered Outcomes and Research Institute and served on the board of the Consortium for Southeastern Healthcare Quality. Dr Ahmad has received grant support from Amgen and Boehringer Ingelheim and consulting fees from Pfizer. Dr Liu has received grants from the National Institute of Diabetes and Digestive and Kidney Diseases (grant R01DK116986), the National Science Foundation (grant 2014554), and the National Center for Advancing Translational Sciences (grant UL1TR002366) and support for attending meetings and/or travel from the National Institutes of Health and the National Science Foundation. Dr McClay has received grant support from PCORI, the National Institutes of Health, and National Institute of General Medical Sciences and served as co-chair of the HL7 Clinical Interoperability Council. The PCORI funding partially supported salaries (Drs Chamberlain, Cooper-DeHoff, Fontil, Todd, Carton, O’Brien, and Pletcher and Mss Shaw, Smith, and Faulkner Modrow) or consulting income (Mr Maeztu). The other authors report no competing interests.

Figures

Figure 1
Figure 1
Trends in 9 blood pressure (BP) control metrics over time by health system. The 24 light colored lines on each plot correspond to the trend over time in the metric for each participating health system. The bolded line is the weighted average across the 24 health systems. CCB, calcium channel blocker; SBP, systolic blood pressure.
Figure 2
Figure 2
Trends in 9 blood pressure (BP) control metrics over time by race/ethnicity. The bolded light blue line is the weighted average across the 24 health systems. CCB, calcium channel blocker; SBP, systolic blood pressure.
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References

    1. Mafi J.N., Craff M., Vangala S., et al. Trends in US ambulatory care patterns during the COVID-19 pandemic, 2019-2021. JAMA. 2022;327(2):237–247. - PMC - PubMed
    1. Patel S.Y., Mehrotra A., Huskamp H.A., Uscher-Pines L., Ganguli I., Barnett M.L. Trends in outpatient care delivery and telemedicine during the COVID-19 pandemic in the US. JAMA Intern Med. 2021;181(3):388–391. - PMC - PubMed
    1. Whaley C.M., Pera M.F., Cantor J., et al. Changes in health services use among commercially insured US populations during the COVID-19 pandemic. JAMA Netw Open. 2020;3(11) - PMC - PubMed
    1. Rose L., Tran L.D., Asch S.M., Vashi A. Assessment of changes in US Veterans Health Administration care delivery methods during the COVID-19 pandemic. JAMA Netw Open. 2021;4(10) - PMC - PubMed
    1. Park S., Stimpson J.P. Trends in self-reported forgone medical care among Medicare beneficiaries during the COVID-19 pandemic. JAMA Health Forum. 2021;2(12) - PMC - PubMed

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