Abstract P255: STUDY OF THE SEVERITY OF COVID-19 IN HYPERTENSIVE PATIENTS IN PRIMARY CARE, IN SPAIN. PRELIMINARY RESULTS.

Abstract

Objective: Decision-making in the management of the COVID-19 pandemic has raised questions related to the disease progression in hypertensive patients according to their BP control and the presence of comorbidities or target organ involvement. It has been reported that HTN can worse the outcomes of patients infected by COVID-19. The aim of this study is to assess the clinical and sociodemographic parameters in this population of hypertensives treated in Primary Care, according to the severity of the disease progression (mild-asymptomatic or those who required hospital admission). Design and Methods: Multicentric, observational, cross-sectional, retrospective and analytical study. The patients were selected through a random sampling in 12 provinces in Spain, among patients older than 18y with treated hypertension and COVID-19 (PCR positive) under the primary care scope (119 investigators). Data collection time was 15 months (IQR= 5), from November 2020 to February 2022, outside the first wave. Results: 1372 patients were recruited (51% women, mean age 67yo), smoking 12.5%, obesity 43.9%, diabetes 27.5%, controlled arterial hypertension 55.9% (BP<140/90). The severity of COVID-19 progression was: mild-asymptomatic 971 (71%), hospital admission 401 (29%), admission to ICU 74 (5%), death 48 (4%). Comparing the progression of the covid-19 disease of patients who requires hospital admission vs mild-asymptomatic, statistically significant differences were found between some comorbidities: COPD 21.7% vs 11.9%, p<0.001; Diabetes 33.7% vs 24.9%, p<0.05; Dyslipidemia 64.6% vs 57.9%, p<0.05; CKD 21.5% vs 11.1%, p<0.01; Stroke 9.5% vs 5.5%, p<0.05; Atrial Fibrillation 17.7% vs 7.2%, p<0.001; Heart Failure 17% vs 5.8%, p<0.01; Ischemic Heart Disease 13.2% vs 4.6%, p<0.001. As well as: GFR <60 ml/min 110 (27%) vs 140 (14%), p<0.001; ACR (median, IQR) 72 mg/g (10-118) vs 62 (7-115), p<0.05 . Conclusions: Among Spanish hypertensive patients in Primary Care, Covid-19 mortality achieves 4%. Some comorbidities such as diabetes, ischemic heart disease, atrial fibrillation, heart failure, stroke, chronic kidney disease or dyslipidemia, in which hypertension itself develop obvious vascular organ damage, results in worsening the outcomes of this population.