Veterans' blood pressure control worsened during the pandemic due to disrupted care

A multi-institution team led by researchers at the White River Junction VA Medical Center in Vermont found that Veterans' blood pressure control worsened due to disrupted care during the COVID-19 pandemic. The findings were published in the journal Medical Care.

The researchers followed a group of nearly 1.65 million Veterans who received their care at VA and who had high blood pressure (hypertension) during two periods-;before the pandemic and during the pandemic. In Veterans with controlled blood pressure, researchers found a 7% decline in control during the pandemic compared to before the pandemic. Longer follow-up intervals were associated with a decreased likelihood of maintaining blood pressure control in both periods.

Most of the difference in control was explained by delays in follow-up care, according to the research team, led by Dr. Caroline Korves. But the pandemic itself was responsible for a small (2%) effect on blood pressure control.

Researchers also discovered that Veterans who had not yet achieved blood pressure control and who experienced longer intervals between follow-up care were modestly more likely to gain control during the pandemic, but not before the pandemic. The finding suggests that providers focused slightly more on people with uncontrolled blood pressure, an appropriate clinical response, according to the team.

"Opportunities for further research into the cause of the pandemic effect-;whether lower maintenance of control stemmed from missed opportunity for treatment modifications, changes in patient behavior, or other factors-and investigating whether a modestly higher likelihood of gaining control was due to focusing on patients with more extreme conditions, would offer valuable insights in how to prevent disruptions in care during similar crises," wrote the researchers.

High blood pressure remains one of the top public health challenges in the country and contributes to serious health problems, like heart disease and kidney failure. It is a modifiable risk factor for heart disease-meaning it can respond to treatment-and is an important marker to track for disruptions in care, according to the research team.

The research was part of the VA Health Services Research and Development Disrupted Care National Project (DCNP), that aims to better understand disruptions in care during the COVID-19 pandemic. The DCNP is led by Dr. Louise Davies, Dr. Amy Justice, and Dr. Anita Vashi, and is based at the White River Junction VA Medical Center, Vermont, with additional sites at West Haven, Connecticut, and Palo Alto, California.