The past year has been difficult. Americans have struggled with a global pandemic, loss of loved ones, isolation that disrupted social networks, stress, unemployment and depression.
Perhaps unsurprisingly, the country’s blood pressure has soared.
On Monday, scientists reported that blood pressure measurements in nearly half a million adults last year increased significantly from the previous year.
These measurements describe the pressure of blood against the walls of the arteries. Over time, high blood pressure can damage the heart, brain, blood vessels, kidneys, and eyes. Sexual function can also be impaired.
“This is very important data that is not surprising but shocking,” said Dr. Donald M. Lloyd-Jones, president of the American Heart Association, who was not involved in the study.
“Even small changes in mean blood pressure across a population,” he added, “can have a huge impact on the number of strokes, heart failure and heart attacks that we are likely to see in the coming months.”
The study, published as a research letter in the journal Circulation, is a stark reminder that even in the midst of a pandemic that has claimed more than 785,000 American lives and disrupted access to health care, chronic diseases still need to be controlled.
Nearly half of all American adults have hypertension or high blood pressure, a chronic condition called the “silent killer” because it can be life-threatening, although it causes few symptoms.
Hypertension can also put people at greater risk of severe illness if they are infected with the coronavirus. (Evidence for this link is mixed, according to the Centers for Disease Control and Prevention.)
The new study, led by researchers at the Cleveland Clinic and Quest Diagnostics, looked at data from hundreds of thousands of employees and family members who participated in wellness programs that track blood pressure and other health indicators such as weight. Participants from all 50 states and the District of Columbia included people who had high blood pressure and normal blood pressure at the start of the study.
“We noticed that people didn’t exercise as much during the pandemic, didn’t get regular care, drank more and slept less,” said Dr. Luke Luffin, lead author, preventive cardiologist, co-director of the Center for Blood Pressure Disorders at the Cleveland Clinic. “We wanted to know if their blood pressure changed during the pandemic?”
The researchers found that blood pressure readings changed little from 2019 to the first three months of 2020, but increased significantly from April 2020 to December 2020, compared to the same period in 2019.
Blood pressure is measured in millimeters of mercury (mm Hg) and consists of two numbers. The first number refers to the systolic pressure when the heart is beating, and the second number refers to the diastolic pressure when the heart is resting between beats. Normal blood pressure is considered to be 120/80 mm Hg. Art. Or less, although there has been debate over the optimal levels for decades.
The new study found that the average monthly change from April 2020 to December 2020 from the previous year was 1.10 to 2.50 mmHg. for systolic blood pressure and 0.14 to 0.53 for diastolic blood pressure.
The increase is true for both men and women in all age groups. Women showed greater increases in both systolic and diastolic blood pressure.
The average age of the study participants was just over 45, of whom just over half were women. But critics said the lack of information on the race and ethnicity of the participants was a significant flaw in the study, as hypertension is far more common among black Americans than among whites or Hispanic Americans.
Black people have also been disproportionately affected by the pandemic. Luffin said that information on race and ethnicity was only available to 6% of the study participants, so the analysis would not make sense.
But when it comes to hypertension, there is a big difference between black Americans and whites and Hispanics, said Dr.Kim Williams, a cardiologist at Rush University Medical Center in Chicago and author of the 2017 National Blood Pressure Guidelines.
“Hypertension has been an epidemic among African Americans for decades,” he said. “Our treatments have improved and our attempts to cause this have improved, but the gap is widening. And we know that the pandemic has affected different cultures and different aspects of society in different ways. ”
The reasons for the overall rise in blood pressure are unclear, Luffin and colleagues said. Causes may include increased alcohol consumption, decreased physical activity, increased stress, reduced doctor visits, and less adherence to medication.
The researchers dismissed the potential weight gain effect known to increase blood pressure, stating that the men in the study lost weight and the women did not gain more weight than usual.
But other experts have pointed out that the average weight gain may mask gains in certain segments of the population.
“This is probably a multifactorial factor,” Lloyd-Jones said, referring to the overall rise in blood pressure. “But I think the important point is that we know that so many people have lost touch with the healthcare system and lost control of blood pressure and diabetes.”
Americans should pay more attention to overall health and treatment of underlying illnesses despite the pandemic, Luffin said, adding that the punishment for not doing so could outlast the coronavirus itself.
“There are also public health implications of not seeing your doctor regularly, eating poorly, or exercising,” he said. “If we think about the long-term consequences, they are potentially more serious.”