The Psychological Impact of Hypertension During COVID-19 Restrictions: Retrospective Case-Control Study

  1. Carissa Bonner
  2. Erin Cvejic
  3. Julie Ayre
  4. Jennifer Isautier
  5. Christopher Semsarian
  6. Brooke Nickel
  7. Carys Batcup
  8. Kristen Pickles
  9. Rachael Dodd
  10. Samuel Cornell
  11. Tessa Copp
  12. Kirsten J McCaffery

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Abstract

It is unclear how people with hypertension are responding to the COVID-19 pandemic given their increased risk, and whether targeted public health strategies are needed.

Objective

This retrospective case-control study compared people with hypertension to matched healthy controls during the COVID-19 lockdown to determine whether they have higher risk perceptions, anxiety, and vaccination intentions.

Methods

Baseline data from a national survey were collected in April 2020 during the COVID-19 lockdown in Australia. People who reported hypertension with no other chronic conditions were randomly matched to healthy controls of similar age, gender, education, and health literacy level. A subset including participants with hypertension was followed up at 2 months after restrictions were eased. Risk perceptions, anxiety, and vaccination intentions were measured in April and June.

Results

Of the 4362 baseline participants, 466 (10.7%) reported hypertension with no other chronic conditions. A subset of 1369 people were followed up at 2 months, which included 147 (10.7%) participants with hypertension. At baseline, perceived seriousness was high for both hypertension and control groups. The hypertension group reported greater anxiety compared to the controls and were more willing to vaccinate against influenza, but COVID-19 vaccination intentions were similar. At follow-up, these differences were no longer present in the longitudinal subsample. Perceived seriousness and anxiety had decreased, but vaccination intentions for both influenza and COVID-19 remained high across groups (>80%).

Conclusions

Anxiety was above normal levels during the COVID-19 lockdown. It was higher in the hypertension group, which also had higher vaccination intentions. Groups that are more vulnerable to COVID-19 may require targeted mental health screening during periods of greater risk. Despite a decrease in perceived risk and anxiety after 2 months of lockdown restrictions, vaccination intentions remained high, which is encouraging for the future prevention of COVID-19.

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  1. Version published to 10.2196/25610
  2. Version published to 10.2196/preprints.25610
  3. ScreenIT

    SciScore for 10.1101/2020.10.12.20211722: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    RandomizationOf 4362 baseline participants, those reporting high blood pressure with no other chronic conditions (n=466) were randomly matched to individual healthy controls based on age (+/-3 years), gender, education and health literacy adequacy (given baseline survey differences(McCaffery et al., 2020)).
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strengths & limitations: The strengths of this study include a large national sample with data during and after lockdown restrictions, that enabled matched case-control analyses between participants with self-reported hypertension and healthy controls and the use of established well validated measures. The sample was recruited via an online panel and social media, and has a low proportion of culturally and linguistically diverse participants. The survey involved non-stratified sampling without targeted recruitment of specific health conditions, and only a subset were included in the longitudinal sub-study. Conclusion: Anxiety was above normal levels for all groups during the COVID-19 lockdown. This was higher in the hypertension group and appeared to translate to higher influenza vaccination intentions. In Australia, where lockdown effectively reduced the spread of COVID-19 and restrictions eased relatively quickly, these differences dissipated after 2 months, but locations with prolonged restrictions may require targeted psychological screening for vulnerable groups. Despite a decrease in perceived seriousness and anxiety after 2 months of lockdown restrictions, vaccination intentions for both influenza and COVID-19 remained high (80%), which is encouraging for future prevention of COVID-19.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  4. Version published to 10.1101/2020.10.12.20211722v1 on medRxiv