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New Study Reveals Surprising Reason For High Blood Pressure—Experts Explain

COVID-19 infection may trigger the development of high blood pressure, new research shows.

Researchers found that COVID-19 infections had a much higher association with hypertension than influenza.

Experts explain the study's findings.

Unfortunately for many, a COVID-19 infection's effects don't end with a negative COVID test. With new variants like EG.5 (dubbed "Eris) and 2.86 (nicknamed "Pirola") (nicknamed "Pirola"), staying up-to-date on the latest COVID research can be instrumental in maintaining health. Experts are still learning about the effects of long COVID, and now, research shows that a COVID-19 infection may cause long-term high blood pressure, or hypertension.

A study published in Hypertension, an American Heart Association (AHA) journal, investigated the development and risk factors associated with persistent high blood pressure in people with COVID-19 infection compared to influenza, a.K.A. The flu.

Researchers analyzed health data from electronic medical records at the Montefiore Health System in Bronx, NY, which serves a large, racially and ethnically diverse population. Researchers looked at 45,398 people with COVID-19 (hospitalized between March 1, 2020, and February 20, 2022) and 13,864 people with influenza without COVID-19 (hospitalized between January 2018 and February 20, 2022) who returned to the hospital system for any medical reasons within an average follow-up period of six months.

The analysis found that 21% of people hospitalized with COVID-19 developed high blood pressure, compared to 11% of those who were not hospitalized for COVID-19, per the news release. Meanwhile, 16% of people hospitalized with influenza developed high blood pressure, and only 4% of those with influenza but not hospitalized developed high blood pressure.

Researchers also found that people hospitalized due to COVID-19 were more than twice as likely to develop persistent hypertension, and those not hospitalized were 1.5 times more likely, compared to both groups of those with influenza (hospitalized and not hospitalized.)

Finally, the study found that those with the highest risk of developing high blood pressure were those with SARS-CoV-2 infections who were over 40 years old, Black adults, or those with preexisting conditions (such as chronic obstructive pulmonary disease, coronary artery disease, or chronic kidney disease). Persistent high blood pressure was also more common among people infected with SARS-CoV-2 who were treated with low blood pressure medications and anti-inflammatory medications, both of which are known to raise blood pressure, during the pandemic.

How can COVID-19 impact my blood pressure?

COVID-19 is an endothelial disease, says Jayne Morgan, M.D., cardiologist and the Clinical Director of the Covid Task Force at the Piedmont Healthcare Corporation in Atlanta, GA. "In other words, it negatively impacts the lining of the veins and arteries, even increasing the risk of developing blood clots," she says. Therefore, Dr. Morgan says it should not be a surprise that it also impacts blood pressure.

In addition to cardiovascular stress and respiratory compromise, inflammation, stress from the pandemic, and reduced physical activity could all contribute to new persistent hypertension in individuals who have no history of hypertension, says Tim Q. Duong, Ph.D., senior investigator of the study and AHA volunteer.

From a public health perspective, a small rise in the population's blood pressure could mean an increased number of hypertension-related complications, such as stroke, heart diseases, and kidney diseases, notes Duong. "These findings should heighten awareness to screen at-risk patients for hypertension after COVID-19 illness," he says.

Why are people more prone to high blood pressure after a COVID-19 infection vs. Influenza?

Duong says that we don't know exactly what causes the increased susceptibility to new hypertension in COVID-19 patients compared to the flu. "We speculate that SARS-CoV-2 could stimulate our body's hormone system that keeps our blood pressure regulated, which could result in hypertension," he notes.

COVID is also a much more severe disease overall, compared to the flu, and affects markedly more people, especially early in the pandemic and before vaccines became available, Duong adds.

Does being vaccinated put people at less risk for developing high blood pressure due to COVID-19?

While it hasn't been well-studied, the assumption is yes, being vaccinated does put people at less risk for developing hypertension as vaccines diminish the severity of infection, says Amesh A. Adalja, M.D., senior scholar at the Johns Hopkins Center for Health Security.

So while it's not a sure thing that you won't have some high blood pressure effects from a COVID infection, staying up to date with your vaccines and booster shots should be your best shot at a less severe infection and less post-COVID complications. (Learn more about the vaccines coming this fall here.)

Do new strains of COVID-19 affect blood pressure more than previous strains?

With new strains like EG.5 and 2.86 circulating, it's normal to wonder if these latest variants boast the same effects as previous COVID strains.

Dr. Morgan says that data shows that the severity of the disease, including hospitalization, greatly contributes to the risk of developing hypertension following COVID-19 infections. "Thus far, the new strains of SARS-Cov-2 continue to cause mild disease as of the date of this publication, and therefore, are expected to impact both temporary and persistent hypertension to a smaller degree than the earlier, more virulent variants that caused hospitalizations at a higher rate," she says.

However, there is a long-term impact of Long COVID on persistent hypertension, of which the consequences are still being measured, adds Dr. Morgan. "One in six Long COVID patients will develop hypertension, most frequently women," she says.

The bottom line

This study illustrates that COVID-19 has impacts on many bodily systems and emphasizes the importance of vaccination and antiviral use to blunt this impact, says Dr. Adalja.

This study also highlights the need to screen patients for hypertension following a COVID-19 illness, especially for those at-risk with multiple comorbidities, and/or direct risk factors for heart disease such as diabetes, increased cholesterol, obesity, and smoking, says Dr. Morgan.

It's important to acknowledge that this study was carried out in a major academic health system in the Bronx, serving a large racially and ethnically diverse population with a high proportion of patients with low socioeconomic status, says Duong. The Bronx was an epicenter of SARS-CoV-2 infection early in the pandemic as well as a few subsequent waves.

This data suggests Black patients with COVID-19 in the U.S. Are more susceptible to developing new hypertension, consistently with some health disparities reported associated with COVID-19 disease, says Duong. "We think that it is important to follow up these patients longer term and to investigate hypertension-related disorders in patients with COVID-19," he says.

This article is accurate as of press time. However, as the COVID-19 pandemic rapidly evolves and the scientific community's understanding of the novel coronavirus develops, some of the information may have changed since it was last updated. While we aim to keep all of our stories up to date, please visit online resources provided by the CDC, WHO, and your local public health department to stay informed on the latest news. Always talk to your doctor for professional medical advice.

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COVID-19 May Have Wreaked Havoc On Another Aspect Of Our Health

As well as being the leading cause of death in the UK in 2020 and 2021, researchers have found that COVID-19 may lead to high blood pressure.

A new study of more than 45,000 hospital patients infected with the virus found a "significant association" between coronavirus and the development of persistent high blood pressure among those with no previous history of the condition.

Research pinpointed that people with COVID-19 over the age of 40, Black adults or those with pre-existing conditions - such as chronic obstructive pulmonary disease (COPD), coronary artery disease or chronic kidney disease - all had an elevated risk of developing high blood pressure, also known as hypertension.

Covid: Read more

"Covid-19 is typically more severe in patients with pre-existing high blood pressure, including higher rates of hospitalisation and mortality compared to people with normal blood pressure," study author Professor Tim Duong, of Albert Einstein College of Medicine and Montefiore Health System in New York City, said.

Duong added that this was the first study to investigate the development and risk factors associated with persistent high blood pressure in people infected with Covid compared to influenza, a similar respiratory virus.

High blood pressure affects around 14 million British adults. (Getty Images)

Researchers found that people hospitalised for COVID-19 were more than twice as likely to develop persistent hypertension compared to people with flu.

"Given the sheer number of people affected by Covid-19 compared to influenza, these statistics are alarming and suggest that many more patients will likely develop high blood pressure in the future, which may present a major public health burden," Prof Duong added.

"These findings should heighten awareness to screen at-risk patients for hypertension after Covid-19 illness to enable earlier identification and treatment for hypertension-related complications, such as cardiovascular and kidney disease."

What is high blood pressure?

According to the British Heart Foundation (BHF), around a quarter of UK adults - or 14.4 million people - have high blood pressure. High blood pressure is classified as having top and bottom numbers greater than or equal to 130/80 mm Hg.

What effect does high blood pressure have?

High blood pressure can put strain on your blood vessels, heart and other organs, and persistent high blood pressure can lead to heart disease, strokes, heart attacks and kidney disease among others.

Signs and symptoms of high blood pressure

The BHF says that most people with high blood pressure feel fine, so it's important to get it checked whenever you go to the GP. Some signs you may have high blood pressure include:

Nosebleeds

Blurred Vision

Shortness of breath

Dizziness

Headaches

Chest pain

Blurred vision can be a sign of high blood pressure. (Getty Images)

High blood pressure causes

According to the NHS, some things that can increase your risk of high blood pressure includes:

Have a relative with high blood pressure

Have a lot of stress

Smoke

Overweight/obese

Eat too much salt and not enough fruit and vegetables

Do not exercise enough

Drink too much alcohol or coffee

Are over 65

Are of black African or black Caribbean descent

It adds that chances of getting high blood pressure can be reduced by maintaining a healthy diet and weight, exercising regularly, not smoking, and drinking minimal alcohol.

Lifestyle changes are the most common treatment for high blood pressure, but medicine is also recommended in some cases.

Watch: Study Suggests Static Exercise May Be the Most Effective Way to Lower Blood Pressure

Plans For Larger Scale Systematic Screenings Could Diagnose Thousands

When applied at a larger scale, such an approach could translate into tens of thousands of new diagnoses, researchers believe.

Conditions such as coronary artery disease, atrial fibrillation and heart failure affect millions of people worldwide, causing a large number of deaths and increasing healthcare costs.

Treatments are available that can prevent stroke or acute heart failure, but systematic screening is not currently common practice.

Those living with conditions such as type 2 diabetes or chronic obstructive pulmonary disease (COPD) - a group of lung conditions that cause breathing difficulties - are at high risk of such conditions.

A team of researchers led by Dr Amy Groenewegen, from the University Medical Centre Utrecht in the Netherlands, has developed a three-step screening process to detect conditions in high-risk people at an early stage.

Study author Dr Groenewegen said: "An easy-to-implement strategy more than doubled the number of new diagnoses of heart failure, atrial fibrillation and coronary artery disease in high-risk patients."

The first step of the team's intervention was getting patients at primary care practices across the Netherlands to fill out a questionnaire on risk factors and symptoms.

Patients who scored above a specified threshold were given a physical examination by a practice nurse focused on signs of heart failure, as well as an ECG and blood test.

Finally, test results were assessed by a GP who referred patients to a cardiologist when it was deemed necessary.

Between June 2019 and January 2023, 1,216 patients took part in the study, of whom 87 percent had type 2 diabetes and 20 percent had COPD.

Half of the patients were subjected to the new screening process, with the other half forming a control group.

After a year, 50 of the 624 participants (8 percent) in the intervention group were newly diagnosed with at least one of heart failure, atrial fibrillation or coronary artery disease.

Only 19 of the 592 participants (3.2 percent) in the control group were diagnosed.

Dr Groenewegen said: "Because there are so many adults in the community with COPD or type 2 diabetes, this approach could translate into tens of thousands of new diagnoses when applied at large.

"In the Netherlands, for example, screening the more than 920,000 patients with COPD and/or type 2 diabetes could identify over 44,000 patients with at least one previously undiagnosed cardiovascular condition."

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