COVID pandemic impact on hypertension management in North-East London: an observational cohort study using electronic health records Article Swipe
Stuart Rison
,
Oliver Redfern
,
Rohini Mathur
,
Isabel Dostal
,
Chris Carvalho
,
Zahra Raisi‐Estabragh
,
John Robson
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1101/2023.08.02.23293505
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1101/2023.08.02.23293505
Background The COVID19 pandemic had a major impact on primary care management of long-term conditions such as hypertension. This observational cohort study of adults with hypertension registered in 193 primary care practices in North-East London between January 2019 and October 2022 investigated the impact of the COVID19 pandemic on the treatment and control of blood pressure including demographic and social inequities. Method and findings In 224,329 adults with hypertension, the proportion with a blood pressure (BP) recorded within the preceding 1 year fell from a 91% pre-pandemic peak to 62% at the end of the pandemic lock-down phase and improved to 77% by the end of the study. The proportion with controlled hypertension (<80 years old, BP ≤140/90mmHg; 80 or more years old: ≤150/90mmHg) for the same time points was 81%, 50% and 60% respectively. Using ‘blood pressure control’ (which considered only patients with a valid blood pressure recording) as the indicator attenuated the reduction to 83%, 80% and 78% respectively. The study used multivariable logistic analysis at four representative time points (Pre-pandemic: April 2019; Pre lockdown: April 2020; Lockdown: April 2021; Post-lockdown: April 2022) to identify temporal, clinical and demographic influences on blood pressure monitoring and control. Pre-pandemic inequities in the management of hypertension were not significantly altered by the pandemic. Throughout the pandemic phases, in comparison to the White ethnic group, the Black ethnic group was less likely to achieve blood pressure control (ORs 0.81 [95% CI = 0.78 to 0.85, p-value<0.001] to 0.87 [95% CI = 0.84 to 0.91, p-value<0.001]). Conversely, the Asian ethnic group was more likely to have controlled blood pressure (ORs 1.09 [95% CI = 1.05 to 1.14, p-value<0.001] to 1.28 [95% CI = 1.23 to 1.32, p-value<0.001]). Younger, male, more affluent individuals, individuals with unknown or unrecorded ethnicity or those untreated were less likely to have blood pressure controlled to target throughout the study. Conclusion The COVID pandemic had a greater impact on blood pressure recording than on blood pressure control. Although recording and control have improved, these had not returned to pre-pandemic levels by the end of the study period. Ethnic inequalities in blood pressure control persisted during the pandemic and remain outstanding.
Related Topics
Concepts
Pandemic
Medicine
Blood pressure
Observational study
Cohort
Cohort study
Demography
Ethnic group
Coronavirus disease 2019 (COVID-19)
Internal medicine
Disease
Infectious disease (medical specialty)
Sociology
Anthropology
Metadata
- Type
- preprint
- Language
- en
- Landing Page
- https://doi.org/10.1101/2023.08.02.23293505
- https://www.medrxiv.org/content/medrxiv/early/2023/08/06/2023.08.02.23293505.full.pdf
- OA Status
- green
- References
- 23
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4385633808
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4385633808Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1101/2023.08.02.23293505Digital Object Identifier
- Title
-
COVID pandemic impact on hypertension management in North-East London: an observational cohort study using electronic health recordsWork title
- Type
-
preprintOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-08-06Full publication date if available
- Authors
-
Stuart Rison, Oliver Redfern, Rohini Mathur, Isabel Dostal, Chris Carvalho, Zahra Raisi‐Estabragh, John RobsonList of authors in order
- Landing page
-
https://doi.org/10.1101/2023.08.02.23293505Publisher landing page
- PDF URL
-
https://www.medrxiv.org/content/medrxiv/early/2023/08/06/2023.08.02.23293505.full.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
greenOpen access status per OpenAlex
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https://www.medrxiv.org/content/medrxiv/early/2023/08/06/2023.08.02.23293505.full.pdfDirect OA link when available
- Concepts
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Pandemic, Medicine, Blood pressure, Observational study, Cohort, Cohort study, Demography, Ethnic group, Coronavirus disease 2019 (COVID-19), Internal medicine, Disease, Infectious disease (medical specialty), Sociology, AnthropologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
- References (count)
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23Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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