Changes in blood pressure patterns of hypertensive patients at Okcheon-gun public health center before and after the COVID-19 pandemic

Abstract

Objective: The purpose of this study was to investigate the effect of discontinuation of periodic follow-up at a public health center in Okcheon-gun, Chungcheongbuk-do on the blood pressure management of hypertensive patients who visited the public health center regularly. The outpatient clinic of the public health center was totally shut down from March 1, 2020 to April 21, 2020, and then re-opened from April 22, focusing on chronic disease patients.Methods: The study group was selected among patients who visited the re-opened clinic from April 22 to the end of May, diagnosed with hypertension, and had a regular follow-up in the public health center. Through the health center medical records, the blood pressure of each patient was analyzed before and after the COVID-19 pandemicResults: Out of a total of 573 patients that visited the center, 306 patients (53.4%) were treated for hypertension, and among them, 235 patients were enrolled. The average blood pressure of all subjects was 136.9/78.0mmHg after the COVID-19 pandemic, which is 4.4mmHg higher systolic blood pressure(SBP)(P < 0.001) and 1.7mmHg higher diastolic blood pressure(DBP)(P < 0.05) than the average blood pressure before the COVID-19 pandemic. For the clinical control status of the SBP, 55% of all subjects maintained the status of ‘controlled’ before and after the COVID-19 pandemic, 15% maintained the ‘uncontrolled’ state, 23% changed from ‘controlled’ to ‘uncontrolled’, and 7.7% changed from ‘uncontrolled’ to ‘controlled’ state. The number of patients with uncontrolled state showed a high increase(McNemar’s chi-square test, P < 0.001).Conclusions: The blood pressure of hypertensive patients managed by Okcheon public health center showed a significant increase of 4.4/1.7mmHg after termination of regular follow-up in response to the COVID-19 pandemic for about 2 months. The number of patients with a clinical status of uncontrolled SBP also increased significantly from 23% to 37%.