Impact of the COVID-19 Pandemic on Arterial Hypertension Monitoring and Control in Portugal

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

METHODS: Publicly available data on performance and health outcomes indicators from the Portuguese National Health Service (NHS) were used to compare pre-pandemic and pandemic periods. Pre-pandemic data were modelled 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) resulting from the decrease in blood pressure (BP) monitoring and in BP records <150/90 mmHg during the first two years of the pandemic. Statistical analyses were conducted using MS Excel®.

RESULTS: There was a 26.4% relative reduction in the number of hypertensive patients under 65 years of age who had at least one BP measurement, and a 21.8% relative reduction in the proportion of patients with controlled disease (BP <150/90 mmHg) during the initial two years of the pandemic. The model projections indicate 176 additional deaths and 3,287 YLL among the Portuguese population of hypertensive patients.

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 compromised monitoring and control of hypertensive patients should be assessed, and proactive measures implemented to mitigate the increase in hypertension-related morbidity and mortality associated with the COVID-19 pandemic.