Abstract
The impact of pre-existing hypertension on outcomes in patients with the novel corona virus (SARS-CoV-2) remains controversial. To address this, we examined the impact of pre-existing hypertension and its treatment on in-hospital mortality in patients admitted to hospital with Covid-19. Using the CAPACITY-COVID patient registry we examined the impact of pre-existing hypertension and guideline-recommended treatments for hypertension on in-hospital mortality in unadjusted and multi-variate-adjusted analyses using logistic regression. Data from 9197 hospitalised patients with Covid-19 (median age 69 [IQR 57-78] years, 60.6% male, n = 5573) was analysed. Of these, 48.3% (n = 4443) had documented pre-existing hypertension. Patients with pre-existing hypertension were older (73 vs. 62 years, p < 0.001) and had twice the occurrence of any cardiac disease (49.3 vs. 21.8%; p < 0.001) when compared to patients without hypertension. The most documented class of anti-hypertensive drugs were angiotensin receptor blockers (ARB) or angiotensin converting enzyme inhibitors (ACEi) (n = 2499, 27.2%). In-hospital mortality occurred in (n = 2020, 22.0%), with more deaths occurring in those with pre-existing hypertension (26.0 vs. 18.2%, p < 0.001). Pre-existing hypertension was associated with in-hospital mortality in unadjusted analyses (OR 1.57, 95% CI 1.42,1.74), no significant association was found following multivariable adjustment for age and other hypertension-related covariates (OR 0.97, 95% CI 0.87,1.10). Use of ACEi or ARB tended to have a protective effect for in-hospital mortality in fully adjusted models (OR 0.88, 95% CI 0.78,0.99). After appropriate adjustment for confounding, pre-existing hypertension, or treatment for hypertension, does not independently confer an increased risk of in-hospital mortality patients hospitalized with Covid-19.
Original language | English |
---|---|
Pages (from-to) | 834-845 |
Number of pages | 12 |
Journal | Hypertension research |
Volume | 45 |
Issue number | 5 |
DOIs | |
Publication status | Published - May 2022 |
Externally published | Yes |
Keywords
- COVID-19
- Hypertension
- Public health
- SARS-Cov-2
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In: Hypertension research, Vol. 45, No. 5, 05.2022, p. 834-845.
Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - The impact of pre-existing hypertension and its treatment on outcomes in patients admitted to hospital with COVID-19
AU - CAPACITY-COVID consortium
AU - McFarlane, Ewan
AU - Linschoten, Marijke
AU - Asselbergs, Folkert W
AU - Lacy, Peter S
AU - Jedrzejewski, Dawid
AU - Williams, Bryan
N1 - Funding Information: We want to express our gratitude and appreciation to all participating sites and researchers part of the CAPACITY-COVID collaborative consortium. CAPACITY-COVID gratefully acknowledges the following organizations for their assistance in the development of the registry and/or coordination regarding the data registration in the collaborating centres: partners of the Dutch CardioVascular Alliance (DCVA), the Dutch Association of Medical Specialists (FMS), and the British Heart Foundation Centres of Research Excellence. In addition, the consortium is grateful for the endorsement of the CAPACITY-COVID initiative by the European Society of Cardiology (ESC), the European Heart Network (EHN), and the Society for Cardiovascular Magnetic Resonance (SCMR). Furthermore, the consortium appreciates the endorsement of CAPACITY-COVID as a flagship research project within the National Institute for Health Research (NIHR)/British Heart Foundation (BHF) Partnership framework for COVID-19 research. Part of this work is supported by the BigData@Heart Consortium, funded by the Innovative Medicines Initiative-2 joint undertaking under grant agreement no. 116074. This joint undertaking receives support from the EU’s Horizon 2020 research and innovation programme and EFP IA. The CAPACITY-COVID registry is supported by the Dutch Heart Foundation (2020B006 CAPACITY), the EuroQol Research Foundation, Novartis Global, Sanofi Genzyme Europe, Novo Nordisk Nederland, Servier Nederland, and Daiichi Sankyo Nederland. The Dutch Network for Cardiovascular Research (WCN), a partner within the CAPACITY-COVID consortium, received funding from the Dutch Heart Foundation (2020B006 CAPACITY) for site management and logistic support in the Netherlands. Marijke Linschoten is supported by the Alexandre Suerman Stipend of the University Medical Centre Utrecht. Folkert W. Asselbergs is supported by CardioVasculair Onderzoek Nederland 2015-12 eDETECT and, along with Bryan Williams is supported by the National Institute of Health Research (NIHR) University College London Hospitals Biomedical Research Centre. Funding Information: BW has received honoraria for lectures on hypertension at medical/scientific meetings supported by Daiichi Sankyo, Pfizer, Menarini, Novartis, Boehringer Ingelheim, Servier. All other authors have nothing to declare. Funding Information: The CAPACITY-COVID registry is supported by the Dutch Heart Foundation (2020B006 CAPACITY), the EuroQol Research Foundation, Novartis Global, Sanofi Genzyme Europe, Novo Nordisk Nederland, Servier Nederland, and Daiichi Sankyo Nederland. The Dutch Network for Cardiovascular Research (WCN), a partner within the CAPACITY-COVID consortium, received funding from the Dutch Heart Foundation (2020B006 CAPACITY) for site management and logistic support in the Netherlands. Marijke Linschoten is supported by the Alexandre Suerman Stipend of the University Medical Centre Utrecht. Folkert W. Asselbergs is supported by CardioVasculair Onderzoek Nederland 2015-12 eDETECT and, along with Bryan Williams is supported by the National Institute of Health Research (NIHR) University College London Hospitals Biomedical Research Centre. Funding Information: We want to express our gratitude and appreciation to all participating sites and researchers part of the CAPACITY-COVID collaborative consortium. CAPACITY-COVID gratefully acknowledges the following organizations for their assistance in the development of the registry and/or coordination regarding the data registration in the collaborating centres: partners of the Dutch CardioVascular Alliance (DCVA), the Dutch Association of Medical Specialists (FMS), and the British Heart Foundation Centres of Research Excellence. In addition, the consortium is grateful for the endorsement of the CAPACITY-COVID initiative by the European Society of Cardiology (ESC), the European Heart Network (EHN), and the Society for Cardiovascular Magnetic Resonance (SCMR). Furthermore, the consortium appreciates the endorsement of CAPACITY-COVID as a flagship research project within the National Institute for Health Research (NIHR)/British Heart Foundation (BHF) Partnership framework for COVID-19 research. Part of this work is supported by the BigData@Heart Consortium, funded by the Innovative Medicines Initiative-2 joint undertaking under grant agreement no. 116074. This joint undertaking receives support from the EU’s Horizon 2020 research and innovation programme and EFP IA. Publisher Copyright: © 2022, The Author(s).
PY - 2022/5
Y1 - 2022/5
N2 - The impact of pre-existing hypertension on outcomes in patients with the novel corona virus (SARS-CoV-2) remains controversial. To address this, we examined the impact of pre-existing hypertension and its treatment on in-hospital mortality in patients admitted to hospital with Covid-19. Using the CAPACITY-COVID patient registry we examined the impact of pre-existing hypertension and guideline-recommended treatments for hypertension on in-hospital mortality in unadjusted and multi-variate-adjusted analyses using logistic regression. Data from 9197 hospitalised patients with Covid-19 (median age 69 [IQR 57-78] years, 60.6% male, n = 5573) was analysed. Of these, 48.3% (n = 4443) had documented pre-existing hypertension. Patients with pre-existing hypertension were older (73 vs. 62 years, p < 0.001) and had twice the occurrence of any cardiac disease (49.3 vs. 21.8%; p < 0.001) when compared to patients without hypertension. The most documented class of anti-hypertensive drugs were angiotensin receptor blockers (ARB) or angiotensin converting enzyme inhibitors (ACEi) (n = 2499, 27.2%). In-hospital mortality occurred in (n = 2020, 22.0%), with more deaths occurring in those with pre-existing hypertension (26.0 vs. 18.2%, p < 0.001). Pre-existing hypertension was associated with in-hospital mortality in unadjusted analyses (OR 1.57, 95% CI 1.42,1.74), no significant association was found following multivariable adjustment for age and other hypertension-related covariates (OR 0.97, 95% CI 0.87,1.10). Use of ACEi or ARB tended to have a protective effect for in-hospital mortality in fully adjusted models (OR 0.88, 95% CI 0.78,0.99). After appropriate adjustment for confounding, pre-existing hypertension, or treatment for hypertension, does not independently confer an increased risk of in-hospital mortality patients hospitalized with Covid-19.
AB - The impact of pre-existing hypertension on outcomes in patients with the novel corona virus (SARS-CoV-2) remains controversial. To address this, we examined the impact of pre-existing hypertension and its treatment on in-hospital mortality in patients admitted to hospital with Covid-19. Using the CAPACITY-COVID patient registry we examined the impact of pre-existing hypertension and guideline-recommended treatments for hypertension on in-hospital mortality in unadjusted and multi-variate-adjusted analyses using logistic regression. Data from 9197 hospitalised patients with Covid-19 (median age 69 [IQR 57-78] years, 60.6% male, n = 5573) was analysed. Of these, 48.3% (n = 4443) had documented pre-existing hypertension. Patients with pre-existing hypertension were older (73 vs. 62 years, p < 0.001) and had twice the occurrence of any cardiac disease (49.3 vs. 21.8%; p < 0.001) when compared to patients without hypertension. The most documented class of anti-hypertensive drugs were angiotensin receptor blockers (ARB) or angiotensin converting enzyme inhibitors (ACEi) (n = 2499, 27.2%). In-hospital mortality occurred in (n = 2020, 22.0%), with more deaths occurring in those with pre-existing hypertension (26.0 vs. 18.2%, p < 0.001). Pre-existing hypertension was associated with in-hospital mortality in unadjusted analyses (OR 1.57, 95% CI 1.42,1.74), no significant association was found following multivariable adjustment for age and other hypertension-related covariates (OR 0.97, 95% CI 0.87,1.10). Use of ACEi or ARB tended to have a protective effect for in-hospital mortality in fully adjusted models (OR 0.88, 95% CI 0.78,0.99). After appropriate adjustment for confounding, pre-existing hypertension, or treatment for hypertension, does not independently confer an increased risk of in-hospital mortality patients hospitalized with Covid-19.
KW - COVID-19
KW - Hypertension
KW - Public health
KW - SARS-Cov-2
UR - http://www.scopus.com/inward/record.url?scp=85127426459&partnerID=8YFLogxK
U2 - https://doi.org/10.1038/s41440-022-00893-5
DO - https://doi.org/10.1038/s41440-022-00893-5
M3 - Article
C2 - 35352027
SN - 0916-9636
VL - 45
SP - 834
EP - 845
JO - Hypertension research
JF - Hypertension research
IS - 5
ER -