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Prognostic Significance of Hypertension History and Blood Pressure on Admission in Japanese Patients with Coronavirus Disease 2019: Integrative Analysis from the Japan COVID-19 Task Force.

HYPERTENSION RESEARCH(2024)

Division of Pulmonary Medicine | Department of Infectious Diseases | Department of Statistical Genetics | Health Science Research and Development Center (HeRD) | Department of Surgery | Institute of Research | Division of Health Medical Intelligence | M&D Data Science Center | Department of Pathology and Tumor Biology | Division of Gastroenterology and Hepatology

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Abstract
The effect of preexisting hypertension on coronavirus disease 2019 (COVID-19) prognosis remains controversial. Additionally, no studies have compared the association between blood pressure (BP) indices on admission and COVID-19 outcomes using preexisting hypertension status. Therefore, this study aimed to investigate the association between preexisting hypertension and COVID-19 outcomes in Japanese patients with COVID-19 and assess the impact of BP indices on admission on clinical outcomes in patients with and without preexisting hypertension. Preexisting hypertension presence was confirmed based on the patient’s clinical history. Critical outcomes were defined as high-flow oxygen use, non-invasive and invasive positive-pressure ventilation, extracorporeal membrane oxygenation, or death during hospitalization. Preexisting hypertension was observed in 64.6% of the patients. Multivariable logistic regression analysis of severe COVID-19 risk factors indicated that preexisting hypertension was independently associated with critical outcomes [adjusted odds ratio (OR): 1.35; 95% confidence interval (CI): 1.05–1.73]. Low or high BP and high pulse pressure on admission were associated with critical outcomes in patients without preexisting hypertension [OR for systolic BP < 100 mmHg: 2.13, 95% CI: 1.21–3.75; OR for high BP stage 2 (160–179 systolic and/or 100–109 mmHg diastolic BP): 2.13, 95% CI: 1.27–3.58; OR for pulse pressure ≥60 mmHg: 1.68, 95% CI: 1.14–2.48]. Preexisting hypertension is a risk factor for critical outcomes in Japanese patients with COVID-19. BP indices are useful biomarkers for predicting COVID-19 outcomes, particularly in patients without preexisting hypertension. Thus, hypertension history, systolic BP, and pulse pressure should be assessed to predict severe COVID-19 outcomes.
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Blood pressure indices,COVID-19,Critical outcomes,Hypertension,Pulse pressure
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要点】:本研究探讨了日本COVID-19患者中高血压病史与入院时血压指标对预后的影响,发现高血压病史是严重预后的独立风险因素,血压指标是预测预后的有效生物标志物。

方法】:通过多变量逻辑回归分析,研究高血压病史和入院时血压指标与COVID-19严重预后的关系。

实验】:研究使用了日本COVID-19任务组的集成数据,对患者的临床病史进行了确认,并将严重预后定义为使用高流量氧气、无创和有创正压通气、体外膜氧合或住院期间死亡。结果显示,高血压病史与严重预后显著相关,入院时低血压、高血压2期和高脉压在无高血压病史的患者中与严重预后相关。