Chandelier
Senior Member (Voting Rights)
Long‐COVID Associated With Incident Hypertension: A Population‐Based Cohort Study
Given the link between blood pressure and cardiovascular morbidity, understanding how long COVID modifies the risk of incident hypertension is clinically important.
The outcome was new‐onset hypertension (International Classification of Diseases, Tenth Revision [ICD‐10] I10). Cox proportional hazards models estimated hazard ratios (HRs), adjusted for age, socioeconomic status, comorbidities, mental health, and pre‐pandemic health care utilization. Analyses were stratified by sex.
Long COVID was associated with increased hypertension risk overall (HR 1.14, 95% CI 1.09–1.20; P<0.001), and in women (HR 1.13, 95% CI 1.05–1.22; P=0.001) and men (HR 1.15, 95% CI 1.05–1.27; P=0.002), with stable estimates across models.
• The association remained consistent after adjustment for socioeconomic factors, cardiometabolic comorbidities, mental health conditions, and health care utilization, and was similar in women and men.
Web | DOI | Journal of the American Heart Association | Open Access
Lindberg, Pia; Wiqvist, Samuel; Lee, Seika; Norrman, Anders; Kisiel, Marta A.; Ståhlberg, Marcus; Nygren‐Bonnier, Malin; Fedorowski, Artur; Carlsson, Axel C.
Abstract
Background
Long COVID has been linked to persistent autonomic and vascular abnormalities, but its impact on hypertension among non‐hospitalized COVID‐19 convalescents remains unclear.Given the link between blood pressure and cardiovascular morbidity, understanding how long COVID modifies the risk of incident hypertension is clinically important.
Methods
We conducted a longitudinal population‐based study using MIRACLE‐S (Multimorbidity Integrated Registry Across Care Levels in Stockholm). Adults aged 18 to 65 years without prior hypertension or hospitalization for acute COVID‐19 were followed from October 2020 to January 2025. Long COVID was defined by a physician‐assigned U09.9 diagnosis.The outcome was new‐onset hypertension (International Classification of Diseases, Tenth Revision [ICD‐10] I10). Cox proportional hazards models estimated hazard ratios (HRs), adjusted for age, socioeconomic status, comorbidities, mental health, and pre‐pandemic health care utilization. Analyses were stratified by sex.
Results
Among 1 221 570 adults, 8365 (0.7%) were diagnosed with long COVID, and 18% developed incident hypertension during follow‐up. Individuals with long COVID (women: n=5578, 16%; men: n=2787, 24%) showed an early and consistently higher cumulative incidence than unexposed individuals (P<0.0001).Long COVID was associated with increased hypertension risk overall (HR 1.14, 95% CI 1.09–1.20; P<0.001), and in women (HR 1.13, 95% CI 1.05–1.22; P=0.001) and men (HR 1.15, 95% CI 1.05–1.27; P=0.002), with stable estimates across models.
Conclusion
Long COVID was associated with elevated risk of incident hypertension in non‐hospitalized COVID‐19 convalescents. These findings suggest SARS‐CoV‐2 infection may contribute to vascular and autonomic dysregulation affecting blood pressure, supporting structured monitoring and risk management in individuals with persistent post‐COVID symptoms.Clinical Perspective
What Is New?
• In this population‐based cohort of more than 1.2 million adults, physician‐diagnosed long COVID was associated with an increased risk of incident hypertension among non‐hospitalized individuals.• The association remained consistent after adjustment for socioeconomic factors, cardiometabolic comorbidities, mental health conditions, and health care utilization, and was similar in women and men.
What Are the Clinical Implications?
• Individuals with persistent post‐COVID symptoms may benefit from structured blood‐pressure monitoring and cardiovascular risk assessment in primary care because long COVID may identify a subgroup at increased risk of developing hypertension.Web | DOI | Journal of the American Heart Association | Open Access