The impact of the COVID-19 pandemic on arterial hypertension monitoring in Portugal

Abstract

Introduction and objectives

This study aimed to evaluate the impact of the COVID-19 pandemic on healthcare provided to patients with arterial hypertension in Portugal.

Methods

The pre-pandemic and pandemic periods were compared using publicly available data on performance and health outcome indicators from the Portuguese National Health Service (NHS). Pre-pandemic data were modeled to project hypothetical scenarios without a pandemic using an exponential smoothing algorithm, and then compared with data collected during the COVID-19 pandemic. A cohort model was developed to estimate the number of all-cause deaths and years of life lost (YLL) due to the reduction in blood pressure (BP) monitoring and in BP records <150/90 mmHg during the first two years of the pandemic. Microsoft Excel® was used for statistical analyses.

Results

There was a 26.4% relative reduction in the number of patients with hypertension under 65 years of age with at least one BP measurement, and a 21.8% relative reduction in the proportion of patients with BP <150/90 mmHg during the first two years of the pandemic. The model projections were 176 additional deaths and 3287 YLL among the Portuguese population of patients with hypertension.

Conclusions

The disruption in BP testing in Portugal during the pandemic increased hypertension-associated morbidity and mortality, with significant YLL. The long-term implications of impaired monitoring of patients with hypertension should be assessed, and proactive strategies implemented to mitigate the increase in hypertension morbidity and mortality associated with the COVID-19 pandemic.