Effects of Hypertension on the Outcomes of COVID-19: A Multicenter Retrospective Cohort Study

Hypertension is thought to be a contributor to mortality in coronavirus disease 2019 (COVID-19) patients; however, that view is controversial, and limited clinical data on the outcomes of COVID-19 in patients with hypertension are available. This study was designed to confirm whether hypertension affects the outcomes of COVID-19. A total of 983 patients with COVID-19 (female, 48%; male, 52%) were enrolled. The COVID-19 patients with hypertension (332, 34%) were older (median age, 72 years versus 58 years; P<0.001); had more comorbidities such as cardio-cerebrovascular diseases, liver and kidney damage; and had a greater inflammatory response than nonhypertensive patients (651, 66%). Significantly higher odds of 60-day mortality (p=0.017) were observed in the hypertensive group, but no significant difference in 28-day mortality (P=0.615) or total 60-day mortality (P=0.791) was observed after adjustment in multivariate analysis. In the hypertensive group, even after adjustment in multivariate analysis, the subgroup of patients 70 years old and older had higher 28-day mortality and total 60-day mortality rates than the other age subgroups (both p<0.05). A total of 297 (89%) COVID-19 patients with hypertension survived, and 35 (11%) died. In addition, compared with hypertensive patients who survived COVID-19, nonsurvivors had more preexisting conditions, including cardiovascular diseases and stroke, higher blood pressure on admission, more severe inflammation, and more liver and kidney damage.In conclusion, hypertension does not directly affect the in-hospital outcome of COVID-19. However, in the hypertensive population aged 70 years and older with COVID-19, the 28- and 60-day mortality rates were significantly elevated. Funding: This work was supported by grants from the PLA Logistics Research Project of China [18CXZ030, 17CXZ008]. Declaration of Interests: None. Ethics Approval Statement: This study was approved by the Ethics Committee of the General Hospital of the Southern Theater Command (Number: Hospital Ethics [2020]-8), and the need to obtain informed consent was waived.