By Paulina Firozi and Hannah Knowles

 

The pandemic has done a number on people’s everyday lives: Shutdowns meant many Americans stayed home for work; shattered routines kept people from school, or the gym or the doctor’s office; grief and loss exacerbated ongoing stress. That all may have contributed to a spike in blood pressure.

American adults’ blood pressure rose markedly in 2020 compared with the year before, according to a study published Monday in the journal Circulation. It was an increase observed across genders and age groups — though researchers found larger increases in women.

The study examined nearly 500,000 adults and their spouses or partners in the 50 states and D.C. who participated in an “employer-sponsored wellness program.” Starting around April 2020, when the spread of the coronavirus in the United States had prompted stay-at-home orders, there was a “significant increase in blood pressure amongst the population studied,” said lead author Luke Laffin, who is the co-director of the Center for Blood Pressure Disorders at the Cleveland Clinic.

By the end of 2020, he said, the increase was even greater.

“It exemplifies the myriad ways the covid-19 pandemic has affected our lives — and the results themselves are not surprising,” said Salim Hayek, a cardiologist at the University of Michigan’s Frankel Cardiovascular Center who was not involved in the study.

The study did not directly examine reasons behind the spike, but Laffin said there are many factors that may have contributed to blood pressure rises last year. For people with diagnosed high blood pressure, also known as hypertension, they may have skipped usual visits to the doctor or may not have been regularly refilling prescriptions. For other people, lifestyle factors, including poor sleep, poor diet choices, increased alcohol consumption and lack of regular exercise, may have contributed to blood pressure increases.

Laffin said stress can also increase blood pressure in “acute settings.” He said people under high amounts of stress can also “do all of those wrong lifestyle things.”

“They don’t eat right, they don’t get as much sleep, they don’t make time for exercise, they gain weight,” he said.

Laffin said it’s difficult to separate chronic stress from those lifestyle factors. “But the end result is going to be the same: We’re going to see an increase in blood pressure,” he said.

Any life change that leads to a sedentary lifestyle is “going to contribute to a little bit of weight gain, a little bit of lack of exercise,” which can lead to rises in people’s blood pressure, said George Bakris, the director of the Comprehensive Hypertension Center at University of Chicago Medicine. Bakris was not involved in the study, but he said Laffin is one of his former trainees.

“If it’s over a short period of time — one month, two months — it’s not a big deal; you can regain whatever you lost,” Bakris said. “But if you’re stuck inside for periods of nine months, 12 months or more, that’s going to be cumulative and it’s not going to be good.”

Blood pressure readings include two numbers: systolic pressure, measured when the heart beats, and diastolic pressure, measured when the heart rests. From April to December 2020, the study found, people’s systolic blood pressure was on average between 1.1 and 2.5 mm Hg higher each month compared with the previous year. Millimeters of mercury, or mm Hg, is a measurement of pressure.

For diastolic blood pressure, average monthly increases ranged from 0.14 to 0.53 mm Hg.

Laffin said the larger increases in blood pressure for women may underline the pandemic’s “increased burden on women compared to men.”

“If there’s someone who is going to have to make sure their kids do the homework and do that virtual learning, oftentimes it’s the women,” he said. “And perhaps they’re not doing the lifestyle things that normally would help keep their blood pressure under better control.”

Uncontrolled hypertension, doctors said, can lead to heart attacks, strokes and heart failure.

Hayek said Laffin’s study may be “looking at the tip of the iceberg.” It said it may underestimate how much the pandemic has affected blood pressure.

Because the study examined a population in employer-sponsored programs, Hayek said it could include people in mid- or upper-level socioeconomic circumstances.

“We can easily extrapolate a much higher increase in lower socioeconomic classes that have really been hit economically and not been able to access care,” Hayek said.

The key takeaway, he said, is the danger of delaying care.

“A lot of people canceled appointments and stopped receiving routine care out of fear of covid-19, which is reasonable,” he said. As a result, things got worse in “so many ways beyond high blood pressure.”

“The pandemic is not over — stress levels are higher than ever. Life has not gone back to normal for a lot of people,” Hayek said. “The overall message here is not to delay care and not to wait for emergencies to happen: Work on prevention, prevention, prevention.”