Physician Update: AHA Special Edition
Read more articles from our most relevant research presented at the 2020 AHA Scientific Sessions.
Clinical Heart and Vascular Center
Professor of Internal Medicine
Vice Provost and Senior Associate Dean for Clinical Research,
Vice President for Health System Research
The COVID-19 pandemic has spread widely across the globe, sickening millions and causing more than 1.4 million deaths. COVID-19 has also had significant economic, social, and psychological impacts, including increased unemployment, social isolation, and disruption in routine medical care. What is not known is whether COVID-19 has impacted cardiovascular preventive care. Specifically, has COVID-19 worsened control of hypertension, diabetes, and obesity at the population level?
We used data from a very large national digital disease management company, Livongo Health Inc., to examine national rates of blood pressure (BP) and glucose control. At #AHA20, we presented our initial BP findings from 73,705 individuals who recorded more than 2.7 million individual BP readings in Livongo’s BP disease management program. We compared trends in monthly mean BP across the U.S. in a pre-COVID-19 period (January 2019 to March 2020) with those seen post-COVID-19 (April 2020 to September 2020).
“To date, these analyses demonstrated that, despite more frequent BP measuring, blood pressure control appears to have worsened during COVID-19. If persistent, this could lead to long-term adverse effects on cardiovascular health.”
The study had several important preliminary findings. First, COVID aside, BP readings demonstrate considerable seasonality (being highest in the winter holiday season and lowest in midsummer). Second, individuals recorded significantly more BP readings per month on average during the COVID-19 pandemic compared with before, perhaps reflecting the fact that patients were home more and/or had greater health interests during that time period. Third, national mean monthly BP readings were significantly higher after COVID compared with matching monthly readings from 2019. This could reflect a combination of factors, including: post-COVID-19 changes in diet, exercise, and resultant weight gain; the effects of increased stress; fewer in-person clinic visits; and/or worse patient therapeutic adherence during COVID-19. Ongoing work will search for explanatory factors for these BP changes as well as determine whether glucose control rates among patients with diabetes were similarly affected by COVID-19.
To date, these analyses demonstrated that, despite more frequent BP measuring, blood pressure control appears to have worsened during COVID-19. If persistent, this could lead to long-term adverse effects on cardiovascular health. Additionally, this research highlighted the exciting potential of using digital “big data” resources to monitor cardiovascular risk factor control on a national scale.