The COVID-19 pandemic affected Americans' health in many ways. Along with the risk of a potentially life-threatening viral infection, people faced higher stress levels and even a heightened risk of certain mental health conditions. Recently, researchers identified another pandemic-related health risk: hypertension, or high blood pressure.
According to a paper published December 6 in the journal Circulation, data from nearly half a million participants showed blood pressure levels increased during the first several months of the COVID-19 pandemic. While participants' blood pressure levels didn't change notably from 2019 to early 2020, they increased between April 2020 and December 2020 among people who had heightened blood pressure and healthy blood pressure before the study.
If a person's blood pressure reaches high enough levels for a long period of time, it can increase the risk of disease—but with some attention to your health, you can reduce your risk of hypertension and the potential issues that can come with it. Here's what you need to know about the pandemic's effects on high blood pressure, and what you can do to decrease your risk.
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What does the research say about the COVID-19 pandemic and its impact on blood pressure?
For the study, which was published as a research letter, researchers from the Cleveland Clinic and Quest Diagnostics looked at data from 464,585 participants who participated in an employer-sponsored wellness program. The participants came from all 50 states, including the District of Columbia, and had their blood pressure levels taken by medical personnel over the course of three years (2018–2020).
According to researchers, blood pressure readings changed very little between from 2019 and January to March 2020, but blood pressure readings were "significantly higher" from April to December 2020—the same time period, researchers note, when people in the US were mostly facing stay-at-home orders to help curb the spread of COVID-19.
Going a bit deeper, researchers saw that the average monthly change in blood pressure readings from April to December 2020, compared to the previous year, was 1.10–2.50 mm Hg for systolic blood pressure, and 0.14 to 0.53 mm Hg for diastolic blood pressure. (Note: The Centers for Disease Control and Prevention (CDC) says a normal blood pressure rate is less than 120/80 mm Hg, or millimeters of mercury). These increases were seen for both men and women in all age groups, though women saw higher increases in both systolic and diastolic blood pressure readings.
It's also important to point out that the categorizations for blood pressure levels—normal, elevated, stage 1 hypertension, and stage 2 hypertension—also changed more during the pandemic period of April to December 2020. According to researchers, 26.8% of participants were "upcategorized," meaning they were given a higher categorization than they had previously, versus 22% of participants who were "downcategorized."
Though the study included a large number of participants, some critics have pointed out a pretty significant weakness in the research: The lack of diversity. As The New York Times recently reported, information on the race and ethnicity was only available for 6% of study participants, which it provides no meaningful data on how the pandemic affected the blood pressure levels for Black Americans, who are more likely to develop high blood pressure than white people, Hispanics, Asians, Pacific Islanders, American Indians, or Alaska Natives do, the CDC says.
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Why did the COVID-19 pandemic raise blood pressure in some—and why is it significant?
Clearly, the COVID-19 pandemic has affected everyone in various ways—and while these data aren't surprising, they aren't shocking, Donald M. Lloyd-Jones, president of the American Heart Association, told The NYT.
First and foremost: The study authors say that weight gain was not the apparent cause for the rise in blood pressure levels—that's because data from weight gain didn't change drastically over the course of the three years. So what was to blame? Researchers aren't entirely sure, but believe reasons are "likely multifactorial," and can include "increased alcohol consumption, less physical activity, emotional stress, and less ongoing medical care (including reduced medication adherence)."
"People weren't seeing their doctors regularly during the pandemic, so they weren't filling prescriptions to manage blood pressure or getting their blood pressure checked by a doctor as frequently, " study co-author Luke Laffin, MD, a cardiologist, co-director of the Center for Blood Pressure Disorders at the Cleveland Clinic, tells Health. "During that time, people were also not demonstrating as much dietary discretion, drinking more alcohol, not sleeping as well, and not exercising as much."
And while the increases in blood pressure don't seem like much (again, a change of 1.10–2.50 mm Hg for systolic blood pressure, and 0.14 to 0.53 mm Hg for diastolic blood pressure), researchers say even small increases of blood pressure at the population level can result in long-term consequences. According to study authors, "a 2-mmHg higher systolic [blood pressure] is associated with significant increases in mortality from stroke and ischemic heart disease among middle-aged adults. Thus, the increase in systolic [blood pressure] among US adults during the COVID-19 pandemic could signal a forthcoming increase in incident cardiovascular disease mortality."
The (slight) silver lining of this research: While Dr. Laffin and his colleagues have been conducting ongoing research on participants' blood pressure throughout 2021, Dr. Laffin suspects the blood pressure levels won't continue to rise—more people have been able to resume their normal activities, like going to the gym to exercise regularly and going to the doctor on a regular basis, he says.
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How can you lower your blood pressure?
If your blood pressure increased during the pandemic or you want to keep it at a healthy level, there's a lot you can do to protect yourself—that's because high blood pressure is often a preventable condition, and the primary risk factors are a person's lifestyle.
According to Sadiya S. Khan, MD, an assistant professor of cardiology and epidemiology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine physician, one of the most important things is to simply know your blood pressure readings. Staying on top of your routine primary care visits, or checking in with your health care provider if you're concerned or curious about your blood pressure, is one way to do that.
"Most people, especially if they've never been told they have hypertension, may not know what it is," says Dr. Khan, who was not involved in the study. "Knowing the number can be very helpful in keeping track of your overall pattern and helping you be proactive in reducing it."
Reducing your risk factors, says Dr. Khan, is another important way to protect yourself from hypertension, whether you have it already or your blood pressure is healthy. Follow your doctor's suggestions for maintaining a healthy weight, quit smoking, drink alcohol in moderation, and do your best to eat a heart-healthy diet that's low in salt. Exercising can also protect against hypertension; the CDC recommends getting at least 150 minutes of physical activity each week (that's about thirty minutes a day, five days a week).
Stress also plays a role in your blood pressure. You may not be able to remove stressors from your life, but you can find healthy ways to cope with stress and hopefully, prevent high blood pressure. So whether you go to therapy, practice mindfulness or meditation, or exercise to cope with stress, Dr. Khan recommends finding a sustainable stress-relieving outlet that works for you.
If you already have high blood pressure, don't be discouraged—your doctor can work with you to pinpoint lifestyle changes and, potentially, a medication that can lower your blood pressure. The most important thing is to make positive changes to protect your health. "Use your awareness of your blood pressure to work with your health care provider and find ways to get it under control," says Dr. Khan.
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