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Impact of Arterial Stiffness on All-Cause Mortality in Patients Hospitalized With COVID-19 in Spain

2020; Lippincott Williams & Wilkins; Volume: 77; Issue: 3 Linguagem: Inglês

10.1161/hypertensionaha.120.16563

1524-4563

Enrique Rodilla, María D. López-Carmona, Xavier Cortés, Lidia Cobos-Palacios, Sergio Canales, Carmen Busca, Samara Campos Escudero, Manuel Rubio‐Rivas, Jesús Díez‐Manglano, Santiago J. Freire Castro, Nuria Vázquez Piqueras, Elisabeth Mateo Sanchis, Paula M. Pesqueira-Fontán, Jeffrey Óskar Magallanes Gamboa, Andrés González García, Víctor Madrid Romero, Lara Tamargo Chamorro, Julio González Moraleja, Javier Villanueva Martínez, Amara González Noya, Ana Suárez-Lombraña, Anyuli Gracia Gutiérrez, Manuel Lorenzo López Reboiro, José Manuel Ramos, Ricardo Gómez‐Huelgas,

Long-Term Effects of COVID-19

Older age and cardiovascular comorbidities are well-known risk factors for all-cause mortality in patients with coronavirus disease 2019 (COVID-19). Hypertension and age are the 2 principal determinants of arterial stiffness (AS). This study aimed to estimate AS in patients with COVID-19 requiring hospitalization and analyze its association with all-cause in-hospital mortality. This observational, retrospective, multicenter cohort study analyzed 12 170 patients admitted to 150 Spanish centers included in the SEMI-COVID-19 Network. We compared AS, defined as pulse pressure ≥60 mm Hg, and clinical characteristics between survivors and nonsurvivors. Mean age was 67.5 (±16.1) years and 42.5% were women. Overall, 2606 (21.4%) subjects died. Admission systolic blood pressure (BP) <120 and ≥140 mm Hg was a predictor of higher all-cause mortality (23.5% and 22.8%, respectively, P<0.001), compared with systolic BP between 120 and 140 mm Hg (18.6%). The 4379 patients with AS (36.0%) were older and had higher systolic and lower diastolic BP. Multivariate analysis showed that AS and systolic BP <120 mm Hg significantly and independently predicted all-cause in-hospital mortality (adjusted odds ratio [ORadj]: 1.27, P=0.0001; ORadj: 1.48, P=0.0001, respectively) after adjusting for sex (males, ORadj: 1.6, P=0.0001), age tertiles (second and third tertiles, ORadj: 2.0 and 4.7, P=0.0001), Charlson Comorbidity Index (second and third tertiles, ORadj: 4.8 and 8.6, P=0.0001), heart failure, and previous and in-hospital antihypertensive treatment. Our data show that AS and admission systolic BP <120 mm Hg had independent prognostic value for all-cause mortality in patients with COVID-19 requiring hospitalization.