Open AccessInteractions between hypertension and inflammatory tone and the effect on blood pressure and outcomes in patients with COVID‐19
Author(s) -
Amar Jacques,
Touront Nicolas,
Ciron Antoine M.,
Pendaries Caroline
Publication year - 2021
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.14137
Subject(s) - medicine , blood pressure , inflammation , context (archaeology) , intensive care unit , c reactive protein , systemic inflammation , neutrophil to lymphocyte ratio , confidence interval , covid-19 , retrospective cohort study , lymphocyte , disease , paleontology , infectious disease (medical specialty) , biology
Arterial hypertension represented one of the most common comorbidities in patients with COVID‐19. However, the impact of hypertension on outcome in COVID‐19 patients is not clear. Close connections between inflammation and blood pressure (BP) have been described, and inflammation plays a key role in the outcome for patients with COVID‐19. Whether hypertension impairs the relationship between inflammation, BP, and outcomes in this context is not known. The aim of this study was to examine the effects of the interactions between inflammation and hypertension status on BP and clinical outcome in patients hospitalized with COVID‐19. We designed a retrospective study in 129 patients hospitalized with COVID‐19 at Toulouse University Hospital. The hospital outcome was admission to the intensive care unit or death. The inflammatory markers were blood C‐reactive protein level (CRP), neutrophil to lymphocyte, and platelet to lymphocyte ratios. We identified strong correlations between CRP ( P < .01) and the other inflammatory markers recorded on admission ( P < .001) with mean BP within 3 days after admission in normotensive patients, whereas these correlations were absent in patients with hypertension. Also, we observed after multivariate adjustment ( P < .05) that CRP level predicted a worse prognosis in hypertensive patients ( relative risk 2.52; 95% confidence intervals [1.03‐ 6.17]; P = .04), whereas CRP was not predictive of outcome in patients without hypertension. In conclusion, the study revealed that in COVID‐19 patients, hypertension impairs the relationship between inflammation and BP and interacts with inflammation to affect prognosis. These findings provide insights that could explain the relationship between hypertension and outcomes in COVID‐19 patients.