Rise in Blood Pressure Observed Among US Adults During the COVID-19 Pandemic

HomeCirculationVol. 145, No. 3Rise in Blood Pressure Observed Among US Adults During the COVID-19 Pandemic Free AccessLetterPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessLetterPDF/EPUBRise in Blood Pressure Observed Among US Adults During the COVID-19 Pandemic Luke J. Laffin, Harvey W. Kaufman, Zhen Chen, Justin K. Niles, Andre R. Arellano, Lance A. Bare and Stanley L. Hazen Luke J. LaffinLuke J. Laffin Correspondence to: Luke J. Laffin, MD, Section of Preventive Cardiology, Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Ave, Mail Code JB1, Cleveland, OH 44195. Email E-mail Address: [email protected] https://orcid.org/0000-0002-3262-792X Heart Vascular and Thoracic Institute, Cleveland Clinic, OH (L.J.L., S.L.H.). *L.J. Laffin and H.W. Kaufman contributed equally. Search for more papers by this author , Harvey W. KaufmanHarvey W. Kaufman Quest Diagnostics, Secaucus, NJ (H.W.K., Z.C., J.K.N., A.R.A., L.A.B.). *L.J. Laffin and H.W. Kaufman contributed equally. Search for more papers by this author , Zhen ChenZhen Chen Quest Diagnostics, Secaucus, NJ (H.W.K., Z.C., J.K.N., A.R.A., L.A.B.). Search for more papers by this author , Justin K. NilesJustin K. Niles Quest Diagnostics, Secaucus, NJ (H.W.K., Z.C., J.K.N., A.R.A., L.A.B.). Search for more papers by this author , Andre R. ArellanoAndre R. Arellano Quest Diagnostics, Secaucus, NJ (H.W.K., Z.C., J.K.N., A.R.A., L.A.B.). Search for more papers by this author , Lance A. BareLance A. Bare Quest Diagnostics, Secaucus, NJ (H.W.K., Z.C., J.K.N., A.R.A., L.A.B.). Search for more papers by this author and Stanley L. HazenStanley L. Hazen Heart Vascular and Thoracic Institute, Cleveland Clinic, OH (L.J.L., S.L.H.). Search for more papers by this author Originally published6 Dec 2021https://doi.org/10.1161/CIRCULATIONAHA.121.057075Circulation. 2022;145:235–237Other version(s) of this articleYou are viewing the most recent version of this article. Previous versions: December 6, 2021: Ahead of Print Hypertension affects almost half of US adults, and blood pressure (BP) control is a national public health priority.1 The coronavirus disease 2019 (COVID-19) pandemic has disrupted both daily life and routine medical care, including the treatment of chronic diseases such as hypertension. Given the unknown impact of the pandemic on BP, this study investigated changes in BP during the pandemic among participants in a US employer-sponsored wellness program.This longitudinal study included employees and their spouses/partners, from all 50 states and the District of Columbia, participating in an annual employer-sponsored wellness program operated by Quest Diagnostics. Participants were required to have BP measured by trained personnel in all 3 years analyzed (2018–2020). The annual BP changes for 2019 versus 2018, January to March 2020 versus 2019, and April to December 2020 versus 2019 were estimated for comparisons between prepandemic (January 2019–March 2020) and pandemic (April–December 2020) periods. Most US jurisdictions put in place COVID-19 stay-at-home orders between mid-March and the start of April 2020, thus establishing prepandemic and pandemic time periods. The mixed model for repeated measures was fitted to assess the adjusted effects of time (pandemic versus prepandemic), sex, and age on changes in BP. Data analyses were performed using SAS Studio 3.6 on SAS version 9.4.This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for reporting cross-sectional studies2 and was deemed exempt by the Western Institutional Review Board in accordance with 45 CFR §160 and §164. Inquiries for data and collaboration inquiries may be directed to [email protected] or to harvey.w.kaufman@questdiagnostics.com.Of 533 645 potential participants in 2018, after applying data exclusions, 464 585 (87%) study participants remained for evaluation with valid data for each of the 3 calendar years analyzed. The cohort included 53.5% women, with a mean (SD) age of 45.7 (11.1) years in 2018.Changes from the preceding year in both systolic and diastolic BP showed no differences between 2019 and January to March 2020 (P=0.8 for systolic and P=0.3 for diastolic BP; Figure). In contrast, annual BP increase was significantly higher in April to December 2020 than 2019 (P<0.0001 for systolic and diastolic BP). During the pandemic period, mean changes each month, compared with the previous year, ranged from 1.10 to 2.50 mm Hg for systolic BP and 0.14 to 0.53 mm Hg for diastolic BP; systolic and diastolic BP increases held true for men and women and across age groups; larger increases were seen in women for both systolic and diastolic BP, in older participants for systolic BP, and in younger participants for diastolic BP (all P<0.0001).Download figureDownload PowerPointFigure. Blood pressure changes during the COVID-19 pandemic. Mean changes (with 95% CIs) in systolic and diastolic blood pressure (mm Hg) from the preceding year, by most recent month of participation, among all participants (A and B) and categorized by time period, age group, and sex (C, women; D, men). P<0.0001 for comparisons of annual changes in systolic blood pressure (mm Hg) between 2019/2018 and April to December 2020/2019 (larger), women (larger), and men, younger and older (larger), respectively; estimate of each of time period, sex, and age group in multivariate mixed model while adjusting for the other 2 factors. P=0.8 for comparisons of changes in systolic blood pressure (mm Hg) between 2019/2018 and January to March 2020/2019. P<0.0001 for comparisons of annual changes in diastolic blood pressure (mm Hg) between 2019/2018 and April to December 2020/2019 (larger), women (larger), and men, younger (larger) and older, respectively; estimate of each of time period, sex, and age group in multivariate mixed model while adjusting for the other 2 factors. P=0.3 for comparisons of changes in diastolic blood pressure (mm Hg) between 2019/2018 and January to March 2020/2019.Participants were next categorized as outlined in the 2017 American BP guidelines (normal, elevated, stage 1 hypertension, and stage 2 hypertension). In the 15-month prepandemic period, compared with the previous year, participant recategorization to a higher versus lower BP category was equivalent (chi-square test, P=0.1; 2019: 24.4% higher/23.6% lower; January–March 2020: 24.9% higher/23.8% lower). In April to December 2020, compared with the prepandemic period, a greater proportion of participants were upcategorized (26.8%) than downcategorized (22.0%; chi-square test, P<0.0001).Weight gain was not the apparent reason for the observed rise in BP during the pandemic, because an average reduction in weight in men was seen in the pandemic period (–0.2 ± 12.4 lb) and the increase in weight of women (0.6 ± 12.2 lb) was the same as the prepandemic period, in 400 067 (86%) participants with weight data in all 3 years.Small population-level increases in BP are associated with increased long-term incidence of major adverse cardiovascular events. For example, a 2-mm Hg higher systolic BP is associated with significant increases in mortality from stroke and ischemic heart disease among middle-aged adults.3 Thus, the increase in systolic BP among US adults during the COVID-19 pandemic could signal a forthcoming increase in incident cardiovascular disease mortality. Reasons for pandemic-associated BP elevations are likely multifactorial, and although weight gain was not the reason, other possible reasons could include increased alcohol consumption, less physical activity, emotional stress, and less ongoing medical care (including reduced medication adherence).4 The finding of greater BP increases in women, compared with men, provides more evidence of the outsized burden that pandemics place on women.5 Although the current cohort is large and includes adults, primarily of middle age, from all 50 states, whether it serves as a representative of US adults is unknown.Continued surveillance of BP among US adults after the pandemic is needed to assess the permanence of the increases noted here. Public health interventions reinforcing the need to address chronic medical problems, even during a pandemic, remain crucial.Article InformationAcknowledgmentsL.J.L. and H.W.K. had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. The authors made the following contributions: concept and design, L.J.L., H.W.K., and S.L.H.; acquisition, analysis, or interpretation of data, L.J.L., H.W.K., S.L.H., J.K.N., Z.C., A.R.A., and L.A.B.; drafting of the article, L.J.L. and H.W.K.; critical revision of the article for important intellectual content, all authors; statistical analysis, Z.C., A.R.A., and J.K.N.; and administrative, technical, or material support, H.W.K. and S.L.H.Sources of FundingS.L.H. is supported by grant P01 HL147823 from the National Institutes of Health and the Office of Dietary Supplements. The National Institutes of Health had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the article; and decision to submit the article for publication.DisclosuresDr Hazen reports having received royalty payments for inventions or discoveries related to cardiovascular diagnostics or therapeutics from Cleveland Heart Laboratory, a fully owned subsidiary of Quest Diagnostics, and Procter & Gamble. Dr Hazen is a paid consultant for Procter & Gamble and Zehna Therapeutics and has received research funds from Proctor & Gamble, Zehna Therapeutics, Pfizer Inc, and Roche Diagnostics. Dr Laffin is a paid consultant for Medtronic and medical advisor for LucidAct Health. Dr Kaufman, J.K. Niles, Z. Chen, Dr Bare, and A.R. Arellano are employees of Quest Diagnostics, and Dr Kaufman, Z. Chen, Dr Bare, and A.R. Arellano own stock in Quest Diagnostics.Footnotes*L.J. Laffin and H.W. Kaufman contributed equally.For Sources of Funding and Disclosures, see page 237.Correspondence to: Luke J. Laffin, MD, Section of Preventive Cardiology, Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Ave, Mail Code JB1, Cleveland, OH 44195. Email laffinl@ccf.orgReferences1. Adams JM, Wright JS. A national commitment to improve the care of patients with hypertension in the US.JAMA. 2020; 324:1825–1826. doi: 10.1001/jama.2020.20356CrossrefMedlineGoogle Scholar2. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.Ann Intern Med. 2007; 147:573–577. doi: 10.7326/0003-4819-147-8-200710160-00010CrossrefMedlineGoogle Scholar3. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R; Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies.Lancet. 2002; 360:1903–1913. doi: 10.1016/s0140-6736(02)11911-8CrossrefMedlineGoogle Scholar4. Czeisler MÉ, Marynak K, Clarke KEN, Salah Z, Shakya I, Thierry JM, Ali N, McMillan H, Wiley JF, Weaver MD, et al. Delay or avoidance of medical care because of COVID-19-related concerns - United States, June 2020.MMWR Morb Mortal Wkly Rep. 2020; 69:1250–1257. doi: 10.15585/mmwr.mm6936a4CrossrefMedlineGoogle Scholar5. Wenham C, Smith J, Davies SE, Feng H, Grépin KA, Harman S, Herten-Crabb A, Morgan R. Women are most affected by pandemics - lessons from past outbreaks.Nature. 2020; 583:194–198. doi: 10.1038/d41586-020-02006-zCrossrefMedlineGoogle Scholar eLetters(0) eLetters should relate to an article recently published in the journal and are not a forum for providing unpublished data. Comments are reviewed for appropriate use of tone and language. Comments are not peer-reviewed. Acceptable comments are posted to the journal website only. Comments are not published in an issue and are not indexed in PubMed. Comments should be no longer than 500 words and will only be posted online. References are limited to 10. Authors of the article cited in the comment will be invited to reply, as appropriate. Comments and feedback on AHA/ASA Scientific Statements and Guidelines should be directed to the AHA/ASA Manuscript Oversight Committee via its Correspondence page. Sign In to Submit a Response to This Article Previous Back to top Next FiguresReferencesRelatedDetailsCited By Newman J and Brook R (2024) The Environment and High Blood Pressure Hypertension, 10.1016/B978-0-323-88369-6.00008-6, (101-105), . Tantisattamo E and Kalantar-Zadeh K (2024) Diet and Hypertension Hypertension, 10.1016/B978-0-323-88369-6.00002-5, (17-48), . Lloyd-Jones D (2024) General Population and Global Cardiovascular Risk Prediction Hypertension, 10.1016/B978-0-323-88369-6.00001-3, (1-16), . Wojciechowska W, Rajzer M, Weber T, Prejbisz A, Dobrowolski P, Ostrowska A, Bilo G, Mancia G, Kreutz R and Januszewicz A (2023) Ambulatory blood pressure monitoring in treated patients with hypertension in the COVID-19 pandemic - The study of European society of hypertension (ESH ABPM COVID-19 study), Blood Pressure, 10.1080/08037051.2022.2161998, 32:1, Online publication date: 31-Dec-2024. Mancia G, Kreutz R, Brunström M, Burnier M, Grassi G, Januszewicz A, Muiesan M, Tsioufis K, Agabiti-Rosei E, Algharably E, Azizi M, Benetos A, Borghi C, Hitij J, Cifkova R, Coca A, Cornelissen V, Cruickshank J, Cunha P, Danser A, Pinho R, Delles C, Dominiczak A, Dorobantu M, Doumas M, Fernández-Alfonso M, Halimi J, Járai Z, Jelaković B, Jordan J, Kuznetsova T, Laurent S, Lovic D, Lurbe E, Mahfoud F, Manolis A, Miglinas M, Narkiewicz K, Niiranen T, Palatini P, Parati G, Pathak A, Persu A, Polonia J, Redon J, Sarafidis P, Schmieder R, Spronck B, Stabouli S, Stergiou G, Taddei S, Thomopoulos C, Tomaszewski M, Van de Borne P, Wanner C, Weber T, Williams B, Zhang Z and Kjeldsen S (2023) 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension, Journal of Hypertension, 10.1097/HJH.0000000000003480, 41:12, (1874-2071), Online publication date: 1-Dec-2023. Jackson S, Woodruff R, Nagavedu K, Fearrington J, Rolka D, Twentyman E, Carton T, Puro J, Denson J, Kappelman M, Paranjape A, Thacker D, Weiner M, Goodman A, Lekiachvili A, Boehmer T, Block J, Ahmad F, Blecker S, Bunnell H, Chang B, Chrischilles E, Christakis D, Cowell L, Curtis J, Fort D, Hanauer D, Hess R, Horne B, Giordano P, Hogan W, Hwang W, Lehmann H, Mayer K, Mosa A, McClay J, Nandhakumar S, Nolan B, Obeid J, Ostasiewski B, Pajor N, Patel L, Rao S, Robinson P, Silverstein J, Stoddard A and Trick W (2023) Association Between Hypertension and Diabetes Control and COVID‐19 Severity: National Patient‐Centered Clinical Research Network, United States, March 2020 to February 2022, Journal of the American Heart Association, 12:21, Online publication date: 7-Nov-2023. Kandzari D, Townsend R, Kario K, Mahfoud F, Weber M, Schmieder R, Pocock S, Tsioufis K, Konstantinidis D, Choi J, East C, Lauder L, Cohen D, Kobayashi T, Schmid A, Lee D, Ma A, Weil J, Agdirlioglu T, Schlaich M, Shetty S, Devireddy C, Lea J, Aoki J, Sharp A, Anderson R, Fahy M, DeBruin V, Brar S, Böhm M, Wang Y, Jay D, McLaurin B, Lomboy C, Allaqaband S, Jan F, Gummadi B, Litt M, Garcia F, Singh J, Brown A, Choi J, Paul A, Sharp A, Coulson J, Nanjundappa A, Thakker G, Campbell J, Honton B, Farah B, Patel M, Gutierrez A, Tyson C, Svetkey L, Fudim M, Pagidipati N, Jones S, Vemulapalli S, Devireddy C, Kulshreshtha A, Wells B, Lea J, Batson B, Wilkins R, Sharif F, Khair A, Pallippattu A, Alhmoudi A, Gaffney B, Cawley C, Gorry C, Hamed H, Carron J, Birrane J, Rosseel L, Lunardi M, Cronin M, McKittrick M, Almagal N, Khalid N, Shehahd Q, Shahzad S, Fezzi S, Tyulkin S, Bel X, Jolly S, Yip G, Schwalm J, Tsang M, Mehta S, Lurz P, Binner C, Obradovic D, Fahr F, Richter I, Rotta detto Loria J, Fengler K, Rommel K, Cuartas M, Lerche M, Hartung P, Münch P, Höllriegel R, John S, Otsuji S, Kusumoto H, Tamaru H, Ishibuchi K, Hasegawa K, Sugimoto K, Kakishita M, Ishii R, Takiuchi S, Yasuda S, Nakabayashi S, Yamamoto W, Higashino Y, Shimatani Y, Taniguchi Y, Tsioufis K, Kasiakogias A, Konstantinidis D, Andrikou E, Konstantinou K, Dimitriadis K, Kalos T, Cohen D, Rene G, Cohen J, Bonanni M, Denker M, Wickramisinghe R, Wilensky R, Kobayashi T, Anjan V, Huan Y, Haught W, Krasnow J, Vasquez A, Gessler C, Roth C, Drenning D, Velasquez E, Soliman G, Murphy J, Jain K, Butler M, Kanitkar M, Laney P, Hunter R, Cheng S, Wright T, Haught W, Chapman N, Arnold A, Nowbar A, Janmohamed A, Corden B, Cook C, Rajkumar C, Keene D, Thompson D, Seligman H, Howard J, Davies J, Sweeney M, Shun-Shin M, Foley M, Quaife N, Al-Lamee R, Hadjiphilippou S, Sen S, Ahmad Y, Kario K, Shimizu H, Waki H, Narita K, Shimpo M, Hoshide S, Komori T, Ogoyama Y, Ogata Y, Oba Y, Bisharat M, Lishmanov A, Bisharat M, Jeffords T, Ghali M, Chia B, Onsrud R, Rough R, Aoki J, Tomii D, Mori F, Kikushima H, Ninomiya K, Yahagi K, Tanabe K, Nakamura K, Komiyama K, Nakase M, Asami M, Setoguchi N, Tanaka T, Horiuchi Y, Watanabe Y, Feldman D, Bergman G, Sherifi I, Kim L, Amin N, Minutello R, Wong S, McCullough S, D'Souza R, Sharp A, Kurdi H, D'Souza R, Statton S, Watkinson T, Bertolet B, Gupta A, Blossom B, Bell C, Hill D, Sierra F, Johnson J, Estess J, Adams J, McDuffie K, Ferguson L, Little N, Ballard R, Williams R, Ikeda W, Calhoun W, Carroll W, Singh A, Hirsh B, Meraj P, Jauhar R, Golwala H, Rueda J, Graham K, Al-Hakim R, Rope R, Kandzari D, Bahrami D, Reedus D, David S, Rehman I, Zakaria K, Choksi N, Kazziha S, Kumar S, Saba S, Steigerwalt S, Sirajeldin Y, Hyder O, Aronow H, Connors A, Shemin D, Bent C, Levy T, Kodoth V, Schlaich M, Kiuchi M, Carnagarin R, Shetty S, Torre S, Levitt H, Chen L, Fan S, Waxman S, Porr W, Mangos G, Smyth B, Lane C, Sader M, Patel K, Rao A, Milford B, Ahluwalia G, Sennott J, Field J, Jena N, Loree S, Graham J, Al-Hesayen A, Bagai A, Shite J, Kozuki A, Suzuki A, Masuko E, Soga F, Asada H, Shibata H, Nagoshi R, Fujiwara R, Kyo S, Miyata T, Kijima Y, Weil J, Griesinger L, Hafer L, Starick R, Keil S, Agdirlioglu T, Desch U, Saito S, Koyama E, Yamanaka F, Yokoyama H, Tobita K, Shishido K, Yamaguchi M, Murakami M, Moriyama N, Takahashi S, Mizuno S, Yokota S, Hayashi T, Yamada T, Yamagishi T, Sugiyama Y, Mashimo Y, Tamaki Y, Tanaka Y, Lee D, Ma A, Yeung A, Noel T, Umana E, Katopodis J, Dixon W, Walton T, Rischin A, Chee A, Leaney A, Fernando H, Hopper I, Bloom J, Fairley J, Stehli J, Segan J, Sharma M, Fitzgerald M, Papandony M, Whyler N, Noaman S, Ali S, Jefferson B, Reyes D, Johnston T, Böhm M, Höfling A, Berger A, Cremers B, Millenaar D, Mahfoud F, Zivanovic I, Lucic J, Dederer J, Lauder L, Fischer P, Kulenthiran S, Ewen S, Bewarder Y, Schmieder R, Bosch A, Schmid A, Ott C, Kannenkeril D, Akarca E, Kistner I, Kolwelter J, Bihlmaier K, Striepe K, Karg M, Günes-Altan M, Anna Friedrich S, Jung S, Dienemann T, Ziakas A, Kouparanis A, Pagiantza A, Peteinidou E, Didagelos M, Psochias P, Shishehbor M, Meade A, Linetsky E, Robinson M, Kotter J, Ziada K, Kotter J, Bachinsky W, Garton A, Stuck J, Papademetriou V, Chung A, Li P, Nagpal S, Remetz M, Shah S and Lynch S (2023) Safety and Efficacy of Renal Denervation in Patients Taking Antihypertensive Medications, Journal of the American College of Cardiology, 10.1016/j.jacc.2023.08.045, 82:19, (1809-1823), Online publication date: 1-Nov-2023. Foster M, Etchin A, Pope C, Hartmann C, Emidio O and Bosworth H (2023) The Impact of COVID-19 on Hypertension and Hypertension Medication Adherence Among Underrepresented Racial and Ethnic Groups: A Scoping Review, Current Hypertension Reports, 10.1007/s11906-023-01262-4, 25:11, (385-394), Online publication date: 1-Nov-2023. Bima P, Giamello J, Rubiolo P, Risi F, Balzaretti P, Lauria G, Vallino D, Lupia E and Morello F (2023) Clinical Presentation and Emergency Department Management Checkpoints of Acute Aortic Syndromes during the First Two Waves of the COVID-19 Pandemic, Journal of Clinical Medicine, 10.3390/jcm12206601, 12:20, (6601) Perli V, Sordi A, Lemos M, Fernandes J, Capucho V, Silva B, de Paula Ramos S, Valdés-Badilla P, Mota J and Branco B (2023) Body composition and cardiorespiratory fitness of overweight COVID-19 survivors in different severity degrees: a cohort study, Scientific Reports, 10.1038/s41598-023-44738-8, 13:1 Bak J, Serné E, Groenwold R, de Valk H, Kramer M, Nieuwdorp M and Verheugt C (2023) Effects of COVID-19 on diabetes care among dutch diabetes outpatients, Diabetology & Metabolic Syndrome, 10.1186/s13098-023-01169-9, 15:1 Zhang V, Fisher M, Hou W, Zhang L and Duong T (2023) Incidence of New-Onset Hypertension Post–COVID-19: Comparison With Influenza, Hypertension, 80:10, (2135-2148), Online publication date: 1-Oct-2023.Abdalla M, Bolen S, Brettler J, Egan B, Ferdinand K, Ford C, Lackland D, Wall H and Shimbo D (2023) Implementation Strategies to Improve Blood Pressure Control in the United States: A Scientific Statement From the American Heart Association and American Medical Association, Hypertension, 80:10, (e143-e157), Online publication date: 1-Oct-2023. Hirschfeld C, Dorbala S, Shaw L, Villines T, Choi A, Better N, Cerci R, Karthikeyan G, Vitola J, Williams M, Al-Mallah M, Berman D, Bernheim A, Biederman R, Bravo P, Budoff M, Bullock-Palmer R, Chen M, DiLorenzo M, Doukky R, Ferencik M, Geske J, Hage F, Hendel R, Koweek L, Murthy V, Narula J, Rodriguez Lozano P, Shah N, Shah A, Soman P, Thompson R, Wolinsky D, Cohen Y, Malkovskiy E, Randazzo M, Lopez-Mattei J, Parwani P, Shetty M, Pascual T, Pynda Y, Dondi M, Paez D, Einstein A, Einstein A, Paez D, Dondi M, Better N, Cerci R, Dorbala S, Karthikeyan G, Pascual T, Shaw L, Villines T, Vitola J, Williams M, Pynda Y, Hinterleitner G, Lu Y, Morozova O, Xu Z, Hirschfeld C, Cohen Y, Malkovskiy E, Randazzo M, Choi A, Lopez-Mattei J and Parwani P (2023) Cardiovascular Testing in the United States during the COVID-19 Pandemic: Volume Recovery and Worldwide Comparison, Radiology: Cardiothoracic Imaging, 10.1148/ryct.220288, 5:5, Online publication date: 1-Oct-2023. Smith L, Muralidharan S, Stanek D and Yorke A (2023) Is Education Enough to Change the Practice of Monitoring of Blood Pressure in Outpatient Clinics? Case Report, Cardiopulmonary Physical Therapy Journal, 10.1097/CPT.0000000000000234, 34:4, (171-176), Online publication date: 1-Oct-2023. Fragala M, Matsushita F, Chen Z and Bare L (2023) Cardiometabolic Risk Increased in Working-Aged Adults During the COVID-19 Pandemic, Metabolic Syndrome and Related Disorders, 10.1089/met.2023.0044, 21:8, (426-434), Online publication date: 1-Oct-2023. Musbat S, Reuveni I and Magnezi R (2023) Social networks as a protective factor for worsened self-perceived health status related to self-perceived changes in loneliness and health conditions in adults aged 50+ during the COVID-19 outbreak, Heliyon, 10.1016/j.heliyon.2023.e20529, 9:10, (e20529), Online publication date: 1-Oct-2023. Mogi M, Tanaka A, Node K, Tomitani N, Hoshide S, Narita K, Nozato Y, Katsurada K, Maruhashi T, Higashi Y, Matsumoto C, Bokuda K, Yoshida Y, Shibata H, Toba A, Masuda T, Nagata D, Nagai M, Shinohara K, Kitada K, Kuwabara M, Kodama T and Kario K (2023) 2023 update and perspectives, Hypertension Research, 10.1038/s41440-023-01398-5 Pathak A, Rudolph U, Saxena M, Zeller T, Müller-Ehmsen J, Lipsic E, Schmieder R, Sievert H, Halbach M, Sharif F, Parise H, Fischell T, Weber M, Kandzari D and Mahfoud F (2023) Alcohol-mediated renal denervation in patients with hypertension in the absence of antihypertensive medications, EuroIntervention, 10.4244/EIJ-D-23-00088, 19:7, (602-611), Online publication date: 1-Sep-2023. Mancia G, Cappuccio F, Burnier M, Coca A, Persu A, Borghi C, Kreutz R and Sanner B (2023) Perspectives on improving blood pressure control to reduce the clinical and economic burden of hypertension, Journal of Internal Medicine, 10.1111/joim.13678, 294:3, (251-268), Online publication date: 1-Sep-2023. Beaney T, Wang W, Schlaich M, Schutte A, Stergiou G, Alcocer L, Alsaid J, Diaz A, Hernandez-Hernandez R, Ishaq M, Jozwiak J, Khan N, Kiru G, McCardle H, Odili A, Pyun W, Romero C, Wang J and Poulter N (2023) Global blood pressure screening during the COVID-19 pandemic: results from the May Measurement Month 2021 campaign, Journal of Hypertension, 10.1097/HJH.0000000000003488, 41:9, (1446-1455), Online publication date: 1-Sep-2023. Rifkin D (2023) Lost in Translation: Why Are Rates of Hypertension Control Getting Worse Over Time?, American Journal of Kidney Diseases, 10.1053/j.ajkd.2023.06.004, Online publication date: 1-Sep-2023. Lee H, Kim E, McCandless M, Johnson R, Singh R and Ding Y (2023) Changes in Cerebrovascular Procedures and Outcomes During COVID-19 Using the National Surgery Quality Improvement Project, World Neurosurgery, 10.1016/j.wneu.2023.06.094, 177, (e540-e553), Online publication date: 1-Sep-2023. Salameh Z, Kaki D, Abu Baker D, Hijazi T, Godino J and Al-Rousan T (2023) Refugee Telehealth Utilization for Hypertension Management During the COVID-19 Pandemic, International Journal of Public Health, 10.3389/ijph.2023.1605913, 68 Kumar S, Diwan N, Mishra A and Bhadoria A Assessment of Risk Factor Progression Due to the COVID-19 Pandemic Among Diagnosed Cases of Hypertension and Diabetes Under the Field Practice Area of Urban Primary Health Centre, Rishikesh, Uttarakhand, Cureus, 10.7759/cureus.42048 McGrath D, Meador M, Wall H and Padwal R (2023) Self-Measured Blood Pressure Telemonitoring Programs: A Pragmatic How-to Guide, American Journal of Hypertension, 10.1093/ajh/hpad040, 36:8, (417-427), Online publication date: 14-Jul-2023. Ferdinand K, Charbonnet R, Laurent J and Villavaso C (2023) Eliminating hypertension disparities in U.S. non-Hispanic black adults: current and emerging interventions, Current Opinion in Cardiology, 10.1097/HCO.0000000000001040, 38:4, (304-310), Online publication date: 1-Jul-2023. Whitsel L, Ablah E, Pronk N, Huneycutt F, Imboden M, Anderson D, Peterson N, Yocke S, Sterling C, Zendell A and Wojcik J (2023) Physical Activity Promotion in the Evolving Work Landscape, American Journal of Health Promotion, 10.1177/08901171231172013b, 37:5, (723-730), Online publication date: 1-Jun-2023. Whitsel L, Ablah E and Richards T (2023) Editors’ Desk – Creating a Movement for Healthy Physical Activity at Work, American Journal of Health Promotion, 10.1177/08901171231172013, 37:5, (722-723), Online publication date: 1-Jun-2023. Nozato Y, Yamamoto K and Rakugi H (2023) Hypertension management before and under the COVID-19 pandemic: lessons and future directions, Hypertension Research, 10.1038/s41440-023-01253-7, 46:6, (1471-1477), Online publication date: 1-Jun-2023. Arling G, Miech E, Myers L, Sexson A and Bravata D (2023) The impact of the COVID-19 pandemic on blood pressure control after a stroke or transient ischemic attack among patients at VA medical centers, Journal of Stroke and Cerebrovascular Diseases, 10.1016/j.jstrokecerebrovasdis.2023.107140, 32:6, (107140), Online publication date: 1-Jun-2023. Nagata J, Yang J, Alsamman S, Al-shoaibi A, Ganson K, Pettee Gabriel K and Baker F (2023) Higher blood pressure and weight observed among early adolescents during the COVID-19 pandemic, American Journal of Preventive Cardiology, 10.1016/j.ajpc.2023.100508, 14, (100508), Online publication date: 1-Jun-2023. Karalis D, Moeller P, Crawford A, Janelli M and Hessen S (2023) Impact of the COVID-19 pandemic on the management of risk factors in patients with stable atherosclerotic vascular disease, American Journal of Preventive Cardiology, 10.1016/j.ajpc.2023.100499, 14, (100499), Online publication date: 1-Jun-2023. Sundarakumar J, Mensegere A, Malo P and Ravindranath V (2023) Impact of the COVID-19 pandemic on some modifiable risk factors of dementia in an aging, rural Indian population, Frontiers in Psychiatry, 10.3389/fpsyt.2023.954557, 14 Keller K, Friedrich O, Treiber J, Quermann A and Friedmann-Bette B (2023) Former SARS-CoV-2 Infection Was Related to Decreased VO2 Peak and Exercise Hypertension in Athletes, Diagnostics, 10.3390/diagnostics13101792, 13:10, (1792) Hennecken C, Doulamis I, McLaughlin L, Avgerinos D, Briasoulis A and Kampaktsis P (2023) Increase in hypertension-related cardiovascular mortality in the United States early in the COVID-19 pandemic, Journal of Cardiovascular Medicine, 10.2459/JCM.0000000000001465, 24:5, (315-316), Online publication date: 1-May-2023. Chamberlain A, Cooper-DeHoff R, Fontil V, Nilles E, Shaw K, Smith M, Lin F, Vittinghoff E, Maeztu C, Todd J, Carton T, O’Brien E, Faulkner Modrow M, Wozniak G, Rakotz M, Sanchez E, Smith S, Polonsky T, Ahmad F, Liu M, McClay J, VanWormer J, Taylor B, Chrischilles E, Wu S, Viera A, Ford D, Hwang W, Knowlton K and Pletcher M (2023) Disruption in Blood Pressure Control With the COVID-19 Pandemic: The PCORnet Blood Pressure Control Laboratory, Mayo Clinic Proceedings, 10.1016/j.mayocp.2022.12.024, 98:5, (662-675), Online publication date: 1-May-2023. Arutyunov G, Tarlovskaya E, Arutyunov A, Polyakov D, Belenkov Y, Konradi A, Lopatin Y, Rebrov A, Tereshchenko S, Chesnikova A, Hayrapetyan H, Babin A, Bakulin I, Bakulina N, Balykova L, Blagonravova A, Boldina M, Butomo M, Vaisberg A, Galyavich A, Gomonova V, Grigoryeva N, Gubareva I, Demko I, Evzerikhina A, Zharkov A, Zateishchikova A, Kamilova U, Kim Z, Kuznetsova T, Kulikov A, Lareva N, Makarova E, Malchikova S, Nedogoda S, Petrova M, Pochinka I, Protasov K, Protsenko D, Ruzan