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IMR Press / RCM / Volume 21 / Issue 4 / DOI: 10.31083/j.rcm.2020.04.113
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Clinical characteristics and outcomes in coronavirus disease 2019 (COVID-19) patients with and without hypertension: a retrospective study
Qi Yao1,2,3,†Jian Ni1,2,3,†Tong-Tong Hu1,2,3Zhu-Lan Cai1,2,3Jin-Hua Zhao1,2,3Qing-Wen Xie1,2,3Chen Liu1,2,3Qing-Qing Wu1,2,3,*
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1 Department of Cardiology, Renmin Hospital of Wuhan University, 430060, Wuhan, P. R. China
2 Cardiovascular Research Institute, Wuhan University, 430060, Wuhan, P. R. China
3 Hubei Key Laboratory of Cardiology, 430060, Wuhan, P. R. China

These authors contributed equally.

Rev. Cardiovasc. Med. 2020 , 21(4), 615–625; https://doi.org/10.31083/j.rcm.2020.04.113
Submitted: 6 June 2020 | Revised: 25 October 2020 | Accepted: 26 October 2020 | Published: 30 December 2020
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract

The novel coronavirus disease (COVID-19) has spread all over the world in a short time. Information about the differences between COVID-19 patients with and without hypertension is limited. To explore the characteristics and outcomes differences between COVID-19 patients with and without hypertension, the medical records and cardiac biomarkers of 414 patients were analyzed. A total of 149 patients had a history of hypertension, while 265 patients did not have hypertension, and the groups were compared based on their clinical characteristics and laboratory findings as well as the hazard risk for composite outcomes, including intensive care unit (ICU) admission, mechanical ventilation, or death. The results are as follows. On admission, 22.1% of patients in hypertension group had elevated high sensitivity troponin I (hs-TNI $>$ 26 pg/mL), which was higher than the proportion in the nonhypertension group (6.4%). Median NT-proBNP levels in patients with hypertension (141.9 pg/mL) were higher than those in patients without hypertension (77.3 pg/mL). Patients in the hypertension group had a higher risk for in-hospital death [HR: 2.57, 95% CI (1.46~4.51)]. However, the impact of hypertension on the prognosis was not significant after adjusting for age and sex. Multivariate Cox hazard regression confirmed that NT-proBNP levels in the highest tertile (upper 75 % of patients with hypertension) was an independent risk factor for in-hospital death in all COVID-19 patients. Taken together, hypertension per se had a modest impact on the prognosis in COVID-19 patients. In COVID-19 patients with and without hypertension, NT-proBNP may be a better predictor of prognosis than hs-TNI.

Keywords
COVID-19
hypertension
clinical outcomes
hs-TNI
NT-proBNP
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