OBJECTIVE: The COVID-19 pandemic had a major impact on medical care. This study evaluated the influence of the pandemic on blood pressure (BP) control and hypertension phenotypes as assessed by office and 24-hour ambulatory BP monitoring (ABPM). DESIGN AND METHODS: Data were collected from 33 centers including Excellence Centers of the European Society of Hypertension. Two groups of patients with treated hypertension were compared. Pandemic group: including participants who had ABPM twice - at visit 2 during the COVID-19 pandemic and visit 1 performed 9-15 months prior to visit 2. Pre-pandemic group: had ABPM at two visits, performed before the pandemic within 9-15 months interval. We determined the following hypertension phenotypes: masked hypertension, white coat hypertension, sustained controlled hypertension (SCH) and sustained uncontrolled hypertension (SUCH). We analyzed the prevalence of phenotypes and their changes between visits. RESULTS: Data of 1419 patients, 616 (43 %) in the pandemic group and 803 (57 %) in the pre-pandemic group, were analyzed. At baseline (visit 1), the prevalence of hypertension phenotypes did not differ between groups. In the pandemic group, the change in hypertension phenotypes between two visits was not significant (p = 0.08). In contrast, in the pre-pandemic group, the prevalence of SCH increased during follow-up (28.8 % vs 38.4 %, p < 0.01) while the prevalence of SUCH decreased (34.2 % vs 27.8 %, p < 0.01). In multivariable adjusted analysis, the only factor influencing negative changes of hypertension phenotypes was the COVID-19 pandemic period. CONCLUSION: These results indicate a negative impact of the COVID-19 pandemic on BP control assessed by hypertension phenotypes.

1st Department of Cardiology Interventional Electrocardiology and Arterial Hypertension Jagiellonian University Medical College Krakow Poland

2nd Prop Department of Internal Medicine Aristotle University Thessaloniki Greece

Cardiology Department Klinikum Wels Grieskirchen Wels Austria

Charité Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt Universität zu Berlin and Berlin Institute of Health Institute of Clinical Pharmacology and Toxicology Berlin Germany

Clinica Medica S Gerardo dei Tintori Hospital University Milano Bicocca Monza Italy

Department of Cardiology S Luca Hospital IRCCS Istituto Auxologico Italiano Milan Italy

Department of Hypertension National Institute of Cardiology Warsaw Poland

Department of Medicine and Surgery University of Milano Bicocca Milan Italy

Hypertension Center STRIDE 7 National and Kapodistrian University of Athens School of Medicine 3rd Department of Medicine Sotiria Hospital Athens Greece

Hypertension Clinic Hadassah Hebrew University Medical Center Mount Scopus Jerusalem and Faculty of Medicine Hadassah Hebrew University School of Medicine Jerusalem Israel

Hypertension Unit Department of Hypertension and Diabetology Medical University of Gdansk Poland

Pole of Cardiovascular Research Institut de Recherche Expérimentale et Clinique and Division of Cardiology Cliniques Universitaires Saint Luc Université Catholique de Louvain Brussels Belgium

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