tetano
Editor, Senior Moderator
Eur J Intern Med
. 2023 Oct 16:S0953-6205(23)00371-0.
doi: 10.1016/j.ejim.2023.10.016. Online ahead of print. Global burden of new-onset hypertension associated with severe acute respiratory syndrome coronavirus 2 infection
Fabio Angeli[SUP] 1 [/SUP], Martina Zappa[SUP] 2 [/SUP], Paolo Verdecchia[SUP] 3 [/SUP]
Affiliations
Several reports documented a specific effect of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on blood pressure (BP), during and after the acute phase of infection. Clinical studies demonstrated that coronavirus disease 2019 (COVID-19) is associated with an increased risk of a persistent increase in BP requiring a new or intensified anti-hypertensive treatment during hospitalization. The picture is further complicated by the evidence from large databases showing an increased risk of new-onset hypertension in COVID-19 survivors on the long term. To further elucidate the epidemiological burden of this phenomenon, we performed a pooled analysis of 4 studies reporting crude incidence rates of new-onset hypertension among COVID-19 patients and contemporary controls. Overall, COVID-19 was associated with a 65% increased risk of new-onset hypertension when compared with controls (p<0.0001); furthermore, incidence of new-onset hypertension was 9% and 5% among COVID-19 patients and controls, respectively. In both the acute phase and recovery from infection, the interaction between spike proteins of SARS-CoV-2 and angiotensin converting enzyme 2 (ACE[SUB]2[/SUB]) receptors remain the most plausible mechanism explaining the raise in BP (ranking new onset hypertension as one of the most prevalent cardiovascular sequelae of COVID-19). In this area of research, it is worth to mention that new variants of SARS-CoV-2 exhibit specific mutations in the spike protein that promotes entry into viral cells via ACE[SUB]2[/SUB]. Thus, the enhanced spike affinity for ACE[SUB]2[/SUB] of new variants has the potential to increase the risk of new-onset hypertension when compared with the original Wuhan strain.
Keywords: Blood pressure; COVID-19; Hypertension; Renin angiotensin system; SARS-CoV-2; Spike protein.
. 2023 Oct 16:S0953-6205(23)00371-0.
doi: 10.1016/j.ejim.2023.10.016. Online ahead of print. Global burden of new-onset hypertension associated with severe acute respiratory syndrome coronavirus 2 infection
Fabio Angeli[SUP] 1 [/SUP], Martina Zappa[SUP] 2 [/SUP], Paolo Verdecchia[SUP] 3 [/SUP]
Affiliations
- PMID: 37852842
- DOI: 10.1016/j.ejim.2023.10.016
Several reports documented a specific effect of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on blood pressure (BP), during and after the acute phase of infection. Clinical studies demonstrated that coronavirus disease 2019 (COVID-19) is associated with an increased risk of a persistent increase in BP requiring a new or intensified anti-hypertensive treatment during hospitalization. The picture is further complicated by the evidence from large databases showing an increased risk of new-onset hypertension in COVID-19 survivors on the long term. To further elucidate the epidemiological burden of this phenomenon, we performed a pooled analysis of 4 studies reporting crude incidence rates of new-onset hypertension among COVID-19 patients and contemporary controls. Overall, COVID-19 was associated with a 65% increased risk of new-onset hypertension when compared with controls (p<0.0001); furthermore, incidence of new-onset hypertension was 9% and 5% among COVID-19 patients and controls, respectively. In both the acute phase and recovery from infection, the interaction between spike proteins of SARS-CoV-2 and angiotensin converting enzyme 2 (ACE[SUB]2[/SUB]) receptors remain the most plausible mechanism explaining the raise in BP (ranking new onset hypertension as one of the most prevalent cardiovascular sequelae of COVID-19). In this area of research, it is worth to mention that new variants of SARS-CoV-2 exhibit specific mutations in the spike protein that promotes entry into viral cells via ACE[SUB]2[/SUB]. Thus, the enhanced spike affinity for ACE[SUB]2[/SUB] of new variants has the potential to increase the risk of new-onset hypertension when compared with the original Wuhan strain.
Keywords: Blood pressure; COVID-19; Hypertension; Renin angiotensin system; SARS-CoV-2; Spike protein.