Stage III Hypertension in Patients After mRNA-Based SARS-CoV-2 Vaccination
2021; Lippincott Williams & Wilkins; Volume: 77; Issue: 6 Linguagem: Inglês
10.1161/hypertensionaha.121.17316
ISSN1524-4563
AutoresSylvain Meylan, Françoise Livio, Maryline Foerster, Patrick James Genoud, François Marguet, Grégoire Wuerzner,
Tópico(s)Long-Term Effects of COVID-19
ResumoHomeHypertensionVol. 77, No. 6Stage III Hypertension in Patients After mRNA-Based SARS-CoV-2 Vaccination Free AccessLetterPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessLetterPDF/EPUBStage III Hypertension in Patients After mRNA-Based SARS-CoV-2 Vaccination Sylvain Meylan, Françoise Livio, Maryline Foerster, Patrick James Genoud, François Marguet, Gregoire Wuerzner and on behalf of the CHUV COVID Vaccination Center Sylvain MeylanSylvain Meylan Correspondence to: Sylvain Meylan, Infectious Diseases Service, Departement of Internal Medicine, Lausanne University Hospital, Rue du Bugnon 46, BH09-788, 1011 Lausanne, Switzerland. Email E-mail Address: [email protected] https://orcid.org/0000-0001-6319-2423 Department of Medicine, Infectious Diseases Service, University Hospital Lausanne and University of Lausanne, Switzerland (S.M.). , Françoise LivioFrançoise Livio Service of Clinical Pharmacology, Department of Laboratories (F.L.), Lausanne University Hospital and University of Lausanne, Switzerland. , Maryline FoersterMaryline Foerster Emergency Department (M.F.), University Hospital of Lausanne, Switzerland. , Patrick James GenoudPatrick James Genoud Nursing Directorate (P.J.G., F.M.), University Hospital of Lausanne, Switzerland. , François MarguetFrançois Marguet Nursing Directorate (P.J.G., F.M.), University Hospital of Lausanne, Switzerland. , Gregoire WuerznerGregoire Wuerzner https://orcid.org/0000-0002-6424-7630 Department of Medicine, Service of Nephrology and Hypertension (G.W.), Lausanne University Hospital and University of Lausanne, Switzerland. and on behalf of the CHUV COVID Vaccination Center Originally published25 Mar 2021https://doi.org/10.1161/HYPERTENSIONAHA.121.17316Hypertension. 2021;77:e56–e57Other version(s) of this articleYou are viewing the most recent version of this article. Previous versions: March 25, 2021: Ahead of Print On January 11, the vaccination center in Lausanne—a city of 140 000 inhabitants in western Switzerland—started the coronavirus disease 2019 (COVID-19) vaccination with mRNA-based vaccines. As of February 9, 13 296 vaccine doses were administered with 12 349 patients receiving the first dose (10501 Pfizer/BioNTech, 1848 Moderna) and 947 receiving a second dose (945 Pfizer/BioNTech, 2 Moderna). The center offers vital signs monitoring for any patient reporting symptoms compatible with a serious adverse event such as suspicion of anaphylactic reaction, malaise, shortness of breath, or pain (eg, headache and chest pain). Any adverse event is medically monitored and those which are serious or unexpected are reported to Swissmedic—the Swiss Agency for Therapeutic Products.We report a case series of 9 patients with stage III hypertension documented within minutes of vaccination during the first 30 days, of which 8 were symptomatic. Inclusion criteria for monitoring are detailed in Table. Vital signs were measured with an oscillometric manometer (Omron Healthcare Europe; a HEM 907-E7) with at least 3 sets of separate values at 5-minute intervals. Median age was 73 (IQR, 22) years and sex distribution was 7 women for 2 men. Eight of 9 patients had a history of arterial hypertension with most patients on antihypertensive therapy. All but one patient received the Pfizer/BioNTech (BNT162b2) vaccine. Of note, the Moderna (mRNA-1273) vaccine was only introduced in late January in Switzerland. One of the patients (n=3) reported a cerebral aneurysm that was coiled within the last year, with a targeted SBP 75 years of age, risk factor groups including hypertension). The mRNA vaccines have received intense scrutiny for immediate hypersensitivity reactions in the wake of an initial report signaling 21 cases of anaphylaxis.3 Hypertension, on the contrary, has not been mentioned explicitly as an adverse event in both safety/immunogenicity trials. However, both phase I/II and III clinical trials for the mRNA vaccines included predominantly younger populations with a mean and median age of 31 and 52 years for the BNT162b2 vaccine4 and 31 and 51 for the mRNA-1273 vaccine.5 Although more data are needed to understand the extent and the mechanism of hypertension after mRNA-based vaccination, our data indicate that in elderly patients with a history of hypertension or significant prior cardiovascular comorbidities, prevaccination control of blood pressure and post-vaccination monitoring, including symptom screening, may be warranted.AcknowledgmentsWe thank all collaborators of the coronavirus disease 2019 (COVID-19) vaccination center in Lausanne. Special thanks to Thierry Calandra for insightful comments.Sources of FundingNone.Disclosures None.FootnotesFor Sources of Funding and Disclosures, see page e57.Correspondence to: Sylvain Meylan, Infectious Diseases Service, Departement of Internal Medicine, Lausanne University Hospital, Rue du Bugnon 46, BH09-788, 1011 Lausanne, Switzerland. Email sylvain.meylan@chuv.chReferences1. Thompson BG, Brown RD, Amin-Hanjani S, Broderick JP, Cockroft KM, Connolly ES, Duckwiler GR, Harris CC, Howard VJ, Johnston SC, et al; American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, and Council on Epidemiology and Prevention; American Heart Association; American Stroke Association. Guidelines for the management of patients with unruptured intracranial aneurysms: a guideline for healthcare professionals from the American Heart Association/American Stroke Association.Stroke. 2015; 46:2368–2400. doi: 10.1161/STR.0000000000000070LinkGoogle Scholar2. 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Authors of the article cited in the comment will be invited to reply, as appropriate.Comments and feedback on AHA/ASA Scientific Statements and Guidelines should be directed to the AHA/ASA Manuscript Oversight Committee via its Correspondence page.Sign In to Submit a Response to This Article Previous Back to top Next FiguresReferencesRelatedDetailsCited By Jeong H, Chun B and Chung Y (2024) COVID-19 vaccine safety: Background incidence rates of anaphylaxis, myocarditis, pericarditis, Guillain-Barré Syndrome, and mortality in South Korea using a nationwide population-based cohort study, PLOS ONE, 10.1371/journal.pone.0297902, 19:2, (e0297902) Mohsenian L, Noroozi Z and Farahmand F (2024) A Possible Case of Hypertensive Crisis With Aortic Dissection After an Anti-COVID-19 Vaccine, Angiology, 10.1177/00033197241232619 Razzaque M (2024) Can adverse cardiac events of the COVID-19 vaccine exacerbate preexisting diseases?, Expert Review of Anti-infective Therapy, 10.1080/14787210.2024.2311837, (1-7) Yan Y, Chen Q, Nuermaimaiti A, Xiao Y, Chang L, Ji H, Sun H, Song Q, Gao Y, Xu J and Wang L (2023) Acceptance of COVID-19 boosters among hypertensive patients in China: A multicenter cross-sectional study, Human Vaccines & Immunotherapeutics, 10.1080/21645515.2023.2283315, 19:3, Online publication date: 15-Dec-2023. 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