Evaluation of blood pressure variation in recovered COVID-19 patients at one-year follow-up: a retrospective cohort study 2024 Azami et al

Abstract
Background
Coronavirus disease 2019 (COVID-19) has various sequelae, one of which might be hypertension. We aimed to evaluate COVID-19’s impact on blood pressure (BP) in non-hospitalized patients at one-year follow-up.

Method
A total of 7,950 consecutive COVID-19 patients regularly visiting our cardiology clinic were retrospectively screened. Patients’ electronic medical records including demographics, comorbidities, vital signs, treatments, and outcomes, were reviewed by two physicians. Individuals with at least one BP measurement in the three months preceding COVID-19 and one measurement in 12 months or more following recovery were included. BP levels before and after COVID-19 were compared using the paired t-test.

Results
5,355 confirmed COVID-19 patients (mean age 55.51 ± 15.38 years) were included. Hypertension (56.9%) and diabetes mellitus (34%) were the predominant comorbidities, and 44.3% had prior major adverse cardiovascular events. Both systolic (126.90 ± 20.91 vs. 139.99 ± 23.94 mmHg, P < 0.001) and diastolic BP (80.54 ± 13.94 vs. 86.49 ± 14.40 mmHg, P < 0.001) were significantly higher post-COVID-19 vs. pre-COVID-19. Notably, 456 (14%) hypertensive patients experienced exacerbated hypertension, while 408 (17%) patients developed new-onset hypertension, overall 864 (16%) of patients had exacerbation or new hypertension. Linear regression analysis revealed that advanced age, smoking, previous cardiovascular events, hypertension, and diabetes mellitus predict increased BP following COVID-19 (P < 0.001).

Conclusion
COVID-19 raised systolic and diastolic BP in the long term in non-hospitalized patients, with over one-sixth developing new-onset or exacerbated hypertension. All patients should be evaluated regarding BP, following COVID-19 recovery, particularly those with the mentioned predictive factors.

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Out of curiosity, tried to find what is hypertension, the mechanism itself, and as best as I can tell... it's unknown. There is a description of what it is and risk factors but the why appears to be, dare I say, (cue spooky theremin) mysterious. Which I guess means lots of possibilities.

The main risk factors are said to be lack of exercise, alcohol, smoking and old age. So given that the reason why blood pressure increases is largely a mystery, I guess we can expect the usual nonsense about healthy lifestyles and exercise, while completely ignoring the broader context. But if a viral infection can be a cause, I really don't think they hold much value. The main factor is age, and one thing that age adds is... drum roll... a cumulative toll of common infections, with increasing consequences as the immune system becomes less able to deal with them.

The easy stuff having mostly figured out in medicine, what's left being complex multisystem processes with multiple possible causes and outcomes, all of which has traditionally been relegated to a mix of secondary shrugging and/or preferring psychological and lifestyle/you did this to yourself models that explain nothing is frankly not looking good.

Even when you look at recent breakthroughs, and there are many, they pretty much always target single causes and mechanisms, and exclusively rely on the progress of technology, without which the whole profession would be stuck in time. It's like the profession basically skipped building up the means and tools to solve those complex problems and is now hitting the wall where most of the remaining problems are the ones they swept under the rug. Lots of stuff under the rug now. So much stuff.

Gotta need a bigger rug to sweep it under. It's rugs all the way down.

Or as they put it in Parks & recreation, it's March 31st every day now.