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Prognostic significance of hypertension history and blood pressure on admission in Japanese patients with coronavirus disease 2019: integrative analysis from the Japan COVID-19 Task Force

Hypertension Research volume 47, pages 639–648 (2024)Cite this article

Abstract

The effect of preexisting hypertension on coronavirus disease 2019 (COVID-19) prognosis remains controversial. Additionally, no studies have compared the association between blood pressure (BP) indices on admission and COVID-19 outcomes using preexisting hypertension status. Therefore, this study aimed to investigate the association between preexisting hypertension and COVID-19 outcomes in Japanese patients with COVID-19 and assess the impact of BP indices on admission on clinical outcomes in patients with and without preexisting hypertension. Preexisting hypertension presence was confirmed based on the patient’s clinical history. Critical outcomes were defined as high-flow oxygen use, non-invasive and invasive positive-pressure ventilation, extracorporeal membrane oxygenation, or death during hospitalization. Preexisting hypertension was observed in 64.6% of the patients. Multivariable logistic regression analysis of severe COVID-19 risk factors indicated that preexisting hypertension was independently associated with critical outcomes [adjusted odds ratio (OR): 1.35; 95% confidence interval (CI): 1.05–1.73]. Low or high BP and high pulse pressure on admission were associated with critical outcomes in patients without preexisting hypertension [OR for systolic BP < 100 mmHg: 2.13, 95% CI: 1.21–3.75; OR for high BP stage 2 (160–179 systolic and/or 100–109 mmHg diastolic BP): 2.13, 95% CI: 1.27–3.58; OR for pulse pressure ≥60 mmHg: 1.68, 95% CI: 1.14–2.48]. Preexisting hypertension is a risk factor for critical outcomes in Japanese patients with COVID-19. BP indices are useful biomarkers for predicting COVID-19 outcomes, particularly in patients without preexisting hypertension. Thus, hypertension history, systolic BP, and pulse pressure should be assessed to predict severe COVID-19 outcomes.

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Acknowledgements

We would like to thank all the participants involved in this study and all members of the Japan COVID-19 Task Force who regularly engage in clinical and research work related to COVID-19. All members contributed to this study.

Funding

Funding

This study was supported by the Japan Agency for Medical Research and Development (grant numbers: JP20nk0101612, JP20fk0108415, JP21jk0210034, JP21km0405211, JP21km0405217, JP21wm0325031, JP20fk0108452, JP21fk0108553, JP21fk0108431, JP22fk0108510, JP21fk0108563, JP21fk0108573, JP22fk0108573, JP22fk0108513, and JP22wm0325031), Japan Science and Technology Agency CREST (grant number: JPMJCR20H2), Japan Science and Technology Agency PRESTO (grant number: JPMJPR21R7), and the Ministry of Health, Labour and Welfare (grant number: 20CA2054).

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Authors and Affiliations

  1. Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan

    Kaori Sakurai, Shotaro Chubachi, Takanori Asakura, Hiromu Tanaka, Shuhei Azekawa, Takashi Shimada, Shiro Otake, Kensuke Nakagawara, Takahiro Fukushima, Ho Lee, Mayuko Watase, Tatsuya Kusumoto, Katsunori Masaki, Hirofumi Kamata, Makoto Ishii & Koichi Fukunaga

  2. Department of Clinical Medicine (Laboratory of Bioregulatory Medicine), Kitasato University School of Pharmacy, Tokyo, Japan

    Takanori Asakura

  3. Department of Respiratory Medicine, Kitasato University, Kitasato Institute Hospital, Tokyo, Japan

    Takanori Asakura

  4. Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan

    Ho Namkoong & Naoki Hasegawa

  5. Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Makoto Ishii

  6. Department of Statistical Genetics, Osaka University Graduate School of Medicine, Suita, Japan

    Yukinori Okada

  7. Department of Genome Informatics, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan

    Yukinori Okada

  8. Laboratory for Systems Genetics, RIKEN Center for Integrative Medical Sciences, Kanagawa, Japan

    Yukinori Okada

  9. Health Science Research and Development Center (HeRD), Tokyo Medical and Dental University, Tokyo, Japan

    Ryuji Koike

  10. Department of Surgery, Keio University School of Medicine, Tokyo, Japan

    Yuko Kitagawa

  11. Institute of Research, Tokyo Medical and Dental University, Tokyo, Japan

    Akinori Kimura

  12. Division of Health Medical Intelligence, Human Genome Center, the Institute of Medical Science, the University of Tokyo, Tokyo, Japan

    Seiya Imoto

  13. M&D Data Science Center, Tokyo Medical and Dental University, Tokyo, Japan

    Satoru Miyano

  14. Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan

    Seishi Ogawa

  15. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan

    Takanori Kanai

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  1. Kaori Sakurai
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Correspondence to Shotaro Chubachi or Takanori Asakura.

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Sakurai, K., Chubachi, S., Asakura, T. et al. Prognostic significance of hypertension history and blood pressure on admission in Japanese patients with coronavirus disease 2019: integrative analysis from the Japan COVID-19 Task Force. Hypertens Res 47, 639–648 (2024). https://doi.org/10.1038/s41440-023-01490-w

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