Middle-aged US adults' blood pressures climbed during the COVID-19 pandemic, likely owing to increased stress and alcohol consumption, decreased physical activity and medication adherence, poor sleep, and disrupted access to healthcare, according to a research letter today in Circulation.
Cleveland Clinic researchers mined data from more than 460,000 US participants in a national Quest Diagnostics employee wellness program who had undergone blood pressure screening every year from 2018 to 2020. Average age was 46 years, and 54% were women.
From April to December 2020, compared with the same period in 2019, monthly systolic blood pressure readings (the top number of a reading), on average, rose 1.10 to 2.50 millimeters of mercury (mm Hg), and diastolic blood pressures (bottom number) rose an average of 0.14 to 0.53 mm Hg. In comparison, blood pressure readings did not change from 2018 to 2019.
From April to December 2020, relative to same period the year before, 26.8% of participants were recategorized into a higher blood pressure category, with only 22% moved to a lower category.
Women had higher systolic and diastolic blood pressure increases than men, while older participants had higher increases in systolic readings, and younger participants saw higher diastolic pressure increases. "The finding of greater BP [blood pressure] increases in women, compared with men, provides more evidence of the outsized burden that pandemics place on women," the study authors wrote.
Increases may show up as heart attacks, strokes
The researchers ruled out weight gain as a possible cause of the increases because men's weights fell overall during the pandemic and stayed the same in women.
"Reasons for pandemic-associated BP elevations are likely multifactorial, and although weight gain was not the reason, other possible reasons could include increased alcohol consumption, less physical activity, emotional stress, and less ongoing medical care (including reduced medication adherence," the researchers said.
Nearly half of American adults have high blood pressure, a leading cause of heart disease and stroke, the authors noted.
In an American Heart Association (AHA) news release, lead author Luke Laffin, MD, said that the study findings highlight the need to monitor, treat, and manage the risk factors for chronic health conditions such as high blood pressure. "Get regular exercise, eat a healthy diet, and monitor your blood pressure and cholesterol," he said. "See your doctor regularly to learn how to manage your cardiovascular risk factors."
The researchers said that their results may not apply to other populations, as the participants were part of an employee wellness program, but that they continue to monitor blood pressure trends to determine if the increases lead to future waves of heart attacks and strokes.
"Unfortunately, this research confirms what is being seen across the country—the COVID-19 pandemic has had and will continue to have long-reaching health impacts across the country and particularly related to uncontrolled hypertension," said Eduardo Sanchez, MD, MPH, AHA chief medical officer for prevention, who was not involved in the study.