Incidence and Risk Factors of New-onset Hypertension Up To 3 years Post SARS-CoV-2 Infection

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Abstract

COVID-19 can trigger new cardiovascular events, including hypertension, in the acute setting. However, few studies have reported sustained new-onset hypertension post-infection. Moreover, these studies have a small sample size, inadequate controls, and a short (< 1 year) follow-up time. This retrospective cohort study of 64,000 COVID-19 patients from the Stony Brook Health System assessed the incidence and risk factors for new-onset hypertension after COVID-19. Contemporary COVID-negative controls were obtained and propensity matched for age, race, sex, ethnicity, and major comorbidities before analyzing outcomes. The primary outcome was new-onset hypertension up to 3 years post index date. About 9.93% hospitalized patients and 4.66% non-hospitalized developed new-onset hypertension after COVID-19. Hospitalized COVID-positive patients were more likely to develop hypertension compared to COVID-negative controls (HR = 1.57, 95%CI [1.35–1.81]) and non-hospitalized COVID-positive controls (HR: 1.42, 95%CI [1.24–1.63]). Non-hospitalized COVID-positive patients were not more likely to develop hypertension compared to COVID-negative controls (HR: 1.05 [0.98–1.13]). COVID-19 was one of the five greatest risk factors for developing hypertension. These findings underscore COVID-19 patients are at increased risk of developing hypertension well beyond the acute phase of the disease. Close long-term follow-up, holistic workups, and vigilant blood pressure screening and/or monitoring for COVID-19 patients is needed.

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