Prospective comparative analysis of the ambulatory blood pressure monitoring changes in patients with hypertension after COVID‑19 in the conditions of the Arctic watch

Abstract

Objective. To conduct a prospective (2-year) comparative analysis of the dynamics of 24-hour ambulatory blood pressure monitoring (ABPM) in patients with arterial hypertension (HTN) and previous COVID-19 infection working in the conditions of the Arctic watch.Design and methods. In the Medical Unit of Gazprom Dobycha Yamburg LLC (GDY) in the polar shift settlement of Yamburg, 347 patients were examined: 222 men (M) and 125 women (W). All of them underwent ABPM according to the standard protocol in 2019 and 2022. Among them, 261 patients had confirmed COVID-19 between 2020 and 2021 and were treated in the Medical Unit of GDY. Among the examined M and W, according to medical history in 2019, 80 % of M (178 from 222 people) and 66 % of W (82 from 125 people) had elevated blood pressure (BP), p = 0,003. Among patients with HTN, 109 M (61,2 %) and 42 W (51,2 %) survived after COVID-19, p = 0,129. They formed observation group (n = 151). Comparison group included HTN patients without COVID-19 (n = 109).Results. In patients with HTN who had COVID-19, ABPM showed an increase in average daily systolic BP (SBP) values after 2 years: from 134,5 (12,3) to 140,5 (11,8) mmHg (p < 0,0001) and diastolic BP (DBP): from 96,6 (14,0) to 105,1 (13,4) mmHg (p < 0,0001), hypertensive load time indices (TI): TI SBP24 (from 49,5 (29,3) to 61,6 (28,1) mmHg (p < 0,0001) and TI DBP24 from 69,3 (30,5) to 83,4 (21,9) mmHg (p < 0,0001), increase in daytime SBP variability (p = 0,048), decrease in daily SBP indices by 1,2 %: from 7,9 (4,6) to 6,7 (4,3) (p = 0,038) and DBP by 2,0 %: from 9,7 (4,8) to 7,7 (4,7) (p = 0,032). Desynchronization of SBP and DBP rhythms were found by chronobiological analysis.Conclusions. A prospective comparative analysis of the dynamics of ABPM in patients with HTN after COVID-19 in the conditions of the Arctic watch showed an increase in the average daily values of SBP and DBP and their daily variability, deterioration in the daily BP profile with an increase in the “night peaker” phenotype. In patients with HTN who did not have COVID-19, a prospective analysis of ABPM showed a significant increase in DBP and average daily hypertensive load of DBP, which may contribute to further cardiovascular remodeling. In patients with HTN who have recovered from COVID-19, desynchronization processes of SBP and DBP rhythms intensify, which requires an in-depth analysis of the chronobiological structure of the rhythm BP.