| Background:The coronavirus disease 2019(COVID-19)pandemic has impacted clinical care worldwide.The COVID-19 outbreak causes hypertensive patients experienced negative emotions such as anxiety and stress,and large fluctuations in blood pressure(BP).If not the BP level uncontrolled,it will aggravate the patient's target organ damage and cause cardiovascular and cerebrovascular complications.Evidence of how this health crisis affected common conditions like BP control is uncertain.Methods:We used longitudinal BP data from an ongoing randomized clinical trial to examine variations in home BP monitored via a smartphone-based application(app)in a total of 7394 elderly hypertensive patients aged 60-80 years stratified by their location in Wuhan(n=283)compared with other provinces of China(n=7 111).Changes in morning systolic BP(SBP)between two groups were analyzed for five 30-day phases during the pandemic by using linear mixed model,including pre-epidemic(Oct 21st to Nov 20th,2019),incubation(Nov 21st to Dec 20th,2019),developing(Dec 21st,2019 to Jan 20th,2020),outbreak(Jan 21st to Feb 20th,2020),and plateau(Feb 21st to Mar 21st,2020).Results:Compared with non-Wuhan areas of China,average morning SBP(adjusted for age,sex,body mass index)in Wuhan patients was significantly higher during the epidemic growth phases,which returned to normal at the plateau.Between-group differences in ?SBP were+2.5,+3.0,and+2.1 mmHg at the incubation,developing and outbreak phases of COVID-19(P<0.001),respectively.Sensitivity analysis showed a similar trend in trajectory pattern of SBP in both the intensive and standard BP control groups of the trial.Patients in Wuhan also had an increased regimen change in antihypertensive drugs during the outbreak compared with non-Wuhan patients.Expectedly,Wuhan patients were more likely to check their BP via the app,while doctors were less likely to monitor the app for BP control during the pandemic.Conclusions:Our data demonstrate that a short-term increase in morning SBP emerged among elderly hypertensive patients in Wuhan during the COVID-19 pandemic,but not in other parts of China.Further study will be needed to understand if these findings extended to other parts of the world substantially affected by the virus.Background:Leukocytes telomere length has been associated with hypertension,but,whether longitudinal telomeres change could serve as a useful predictive tool in hypertension remains uncertain.This study aimed to examine the longitudinal trajectory of leukocytes telomere length in a population-based prospective study of 1108 individuals with hypertension.Methods:Leukocytes telomere length were measured at baseline and again after a mean 2.5 years of follow-up.Annual telomere attrition rate was calculated as(follow-up telomeres-baseline telomeres)/follow-up years,and participants were categorized into the shorten and the lengthen groups.Results:Age as an independent predictor was inversely associated with baseline telomeres and follow-up telomeres.Results showed that telomere lengthening was significantly correlated with decreased systolic blood pressure(SBP)(?=-3.28;P=0.02)and pulse pressure(PP)(?=-2.53;P=0.02),and the differences were respectively-3.3 mmHg(95%CI,-6.2 to-0.3;P=0.03)in ?SBP and-2.4 mmHg(95%CI,-4.9 to-0.1;P=0.04)in ?PP between two groups after adjustment for vascular risk factors and baseline blood pressures.When stratified by age and gender,the correlations were observed in women and patients?60 years.Furthermore,among patients using calcium channel blocker(CCB)and angiotensin receptor blocker(ARB),those with telomeres lengthening showed a significantly lower level of ?SBP and ?PP.There was no correlation between telomere attrition and incidence of cardiovascular events.Conclusion:Our data indicated that increased telomere length of leukocytes was associated with decreased SBP and PP,particularly for patients who received CCB and ARB,supporting that telomere attrition may provide new sight in clinical intervention for hypertension. |
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