Impaired blood pressure regulation in post-COVID-19 postural orthostatic tachycardia syndrome: novel disease mechanisms beyond sinus tachycardia
Johansson, Madeleine LU
; Stahlberg, Marcus
; Ricci, Fabrizio
LU
; Lewinter, Christian
; Hamrefors, Viktor
LU
; Nilsson, Peter
LU
; Sutton, Richard
LU
and Fedorowski, Artur
LU
(2024)
American Heart Association (AHA) Congress Scientific Sessions 2024
In Circulation
150(Suppl_1).
- Abstract
- Background: Postural orthostatic tachycardia syndrome (POTS) is a prevalent cardiovascular disorder after COVID-19 infection. Although POTS is characterized by the presence of sinus tachycardia, other hemodynamic disturbances including blood pressure (BP) regulation, remain largely unexplored.
Aims: We investigated BP changes using 24-hour ambulatory-BP-monitoring in patients with new-onset POTS after COVID-19 compared with pre-pandemic healthy controls.
Methods: We performed a case-control study in 100 verified COVID-19 patients with new-onset POTS (mean age 40.0±12.9 years, 85% women) diagnosed by positive head-up tilt-testing versus 100 healthy controls (mean age 45.0±14.6 years, 70% women) from a population-based... (More) - Background: Postural orthostatic tachycardia syndrome (POTS) is a prevalent cardiovascular disorder after COVID-19 infection. Although POTS is characterized by the presence of sinus tachycardia, other hemodynamic disturbances including blood pressure (BP) regulation, remain largely unexplored.
Aims: We investigated BP changes using 24-hour ambulatory-BP-monitoring in patients with new-onset POTS after COVID-19 compared with pre-pandemic healthy controls.
Methods: We performed a case-control study in 100 verified COVID-19 patients with new-onset POTS (mean age 40.0±12.9 years, 85% women) diagnosed by positive head-up tilt-testing versus 100 healthy controls (mean age 45.0±14.6 years, 70% women) from a population-based cohort with negative active standing test, no history of syncope, orthostatic intolerance, or endocrine disease. We analyzed 24-hour Systolic BP (SBP) and hypotensive SBP episodes (<80, <90, and <100mmHg).
Results: Study characteristics are illustrated in the Table. Post-COVID-19 POTS patients had significantly higher nighttime-SBP, but not daytime-SBP, and more daytime SBP hypotensive episodes (<80, <90, and <100 mmHg, Figure) compared with controls. Non-dipper (34% vs 19%, p<0.001) and reverse dipper patterns (9% vs 0 %, <0.001) were more frequent in post-COVID-19 POTS. In the logistic regression, post-COVID-19 POTS was associated with significantly higher mean 24h SBP (odds ratio (OR) 1.08, 95%CI 1.04-1.11, p<0.001) and nighttime SBP (OR 1.07, 95%CI 1.04-1.10, p<0.001), independently of age and sex.
Conclusions: Post-COVID-19 POTS patients demonstrate higher mean 24h and nighttime systolic BP, and show signs of disrupted BP regulation compared with healthy controls. They also have more daytime hypotensive episodes. Future studies are needed to assess if post-COVID-19 POTS patients may benefit from tailored BP therapy. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/25aa15a4-eee7-4e1d-806d-315db2e5c341
- author
- Johansson, Madeleine
LU
; Stahlberg, Marcus
; Ricci, Fabrizio
LU
; Lewinter, Christian
; Hamrefors, Viktor
LU
; Nilsson, Peter
LU
; Sutton, Richard
LU
and Fedorowski, Artur
LU
- organization
- publishing date
- 2024-11-12
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Circulation
- volume
- 150
- issue
- Suppl_1
- article number
- Abstract 4125636
- publisher
- Lippincott Williams & Wilkins
- conference name
- American Heart Association (AHA) Congress Scientific Sessions 2024
- conference location
- Chicago, United States
- conference dates
- 2024-11-16 - 2024-11-18
- ISSN
- 1524-4539
- DOI
- 10.1161/circ.150.suppl_1.4125636
- project
- Long-Haul Post-COVID-19 Symptoms Presenting as Postural Orthostatic Tachycardia Syndrome and Other Cardiovascular Dysautonomias
- language
- English
- LU publication?
- yes
- id
- 25aa15a4-eee7-4e1d-806d-315db2e5c341
- date added to LUP
- 2024-11-17 01:14:36
- date last changed
- 2025-04-04 15:01:28
@misc{25aa15a4-eee7-4e1d-806d-315db2e5c341,
abstract = {{Background: Postural orthostatic tachycardia syndrome (POTS) is a prevalent cardiovascular disorder after COVID-19 infection. Although POTS is characterized by the presence of sinus tachycardia, other hemodynamic disturbances including blood pressure (BP) regulation, remain largely unexplored.<br/><br/>Aims: We investigated BP changes using 24-hour ambulatory-BP-monitoring in patients with new-onset POTS after COVID-19 compared with pre-pandemic healthy controls.<br/><br/>Methods: We performed a case-control study in 100 verified COVID-19 patients with new-onset POTS (mean age 40.0±12.9 years, 85% women) diagnosed by positive head-up tilt-testing versus 100 healthy controls (mean age 45.0±14.6 years, 70% women) from a population-based cohort with negative active standing test, no history of syncope, orthostatic intolerance, or endocrine disease. We analyzed 24-hour Systolic BP (SBP) and hypotensive SBP episodes (<80, <90, and <100mmHg).<br/><br/>Results: Study characteristics are illustrated in the Table. Post-COVID-19 POTS patients had significantly higher nighttime-SBP, but not daytime-SBP, and more daytime SBP hypotensive episodes (<80, <90, and <100 mmHg, Figure) compared with controls. Non-dipper (34% vs 19%, p<0.001) and reverse dipper patterns (9% vs 0 %, <0.001) were more frequent in post-COVID-19 POTS. In the logistic regression, post-COVID-19 POTS was associated with significantly higher mean 24h SBP (odds ratio (OR) 1.08, 95%CI 1.04-1.11, p<0.001) and nighttime SBP (OR 1.07, 95%CI 1.04-1.10, p<0.001), independently of age and sex.<br/><br/>Conclusions: Post-COVID-19 POTS patients demonstrate higher mean 24h and nighttime systolic BP, and show signs of disrupted BP regulation compared with healthy controls. They also have more daytime hypotensive episodes. Future studies are needed to assess if post-COVID-19 POTS patients may benefit from tailored BP therapy.}},
author = {{Johansson, Madeleine and Stahlberg, Marcus and Ricci, Fabrizio and Lewinter, Christian and Hamrefors, Viktor and Nilsson, Peter and Sutton, Richard and Fedorowski, Artur}},
issn = {{1524-4539}},
language = {{eng}},
month = {{11}},
note = {{Conference Abstract}},
number = {{Suppl_1}},
publisher = {{Lippincott Williams & Wilkins}},
series = {{Circulation}},
title = {{Impaired blood pressure regulation in post-COVID-19 postural orthostatic tachycardia syndrome: novel disease mechanisms beyond sinus tachycardia}},
url = {{http://dx.doi.org/10.1161/circ.150.suppl_1.4125636}},
doi = {{10.1161/circ.150.suppl_1.4125636}},
volume = {{150}},
year = {{2024}},
}