Incidence and risk factors of new-onset hypertension up to 3 years post SARS-CoV-2 infection

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% of hospitalized patients and 4.66% of non-hospitalized patients developed new-onset hypertension after COVID-19. Hospitalized COVID-positive patients were more likely to develop hypertension compared to COVID-negative controls (Hazard Ratio [HR] = 1.57, 95% Confidence Interval [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 than COVID-negative controls (HR: 1.05, 95%CI [0.98–1.13]). COVID-19 was one of the five greatest risk factors for developing hypertension. COVID-19 patients are at increased risk of developing hypertension beyond the acute phase of the disease compared to controls. Long-term follow-up, holistic workups, and vigilant blood pressure screening and/or monitoring for COVID-19 patients are needed.