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1.
Hypertension ; 77(3): 846-855, 2021 03 03.
Artigo em Inglês | MEDLINE | ID: mdl-33325240

RESUMO

Hypertension has been identified as a risk factor for coronavirus disease 2019 (COVID-19) and associated adverse outcomes. This study examined the association between preinfection blood pressure (BP) control and COVID-19 outcomes using data from 460 general practices in England. Eligible patients were adults with hypertension who were tested or diagnosed with COVID-19. BP control was defined by the most recent BP reading within 24 months of the index date (January 1, 2020). BP was defined as controlled (<130/80 mm Hg), raised (130/80-139/89 mm Hg), stage 1 uncontrolled (140/90-159/99 mm Hg), or stage 2 uncontrolled (≥160/100 mm Hg). The primary outcome was death within 28 days of COVID-19 diagnosis. Secondary outcomes were COVID-19 diagnosis and COVID-19-related hospital admission. Multivariable logistic regression was used to examine the association between BP control and outcomes. Of the 45 418 patients (mean age, 67 years; 44.7% male) included, 11 950 (26.3%) had controlled BP. These patients were older, had more comorbidities, and had been diagnosed with hypertension for longer. A total of 4277 patients (9.4%) were diagnosed with COVID-19 and 877 died within 28 days. Individuals with stage 1 uncontrolled BP had lower odds of COVID-19 death (odds ratio, 0.76 [95% CI, 0.62-0.92]) compared with patients with well-controlled BP. There was no association between BP control and COVID-19 diagnosis or hospitalization. These findings suggest BP control may be associated with worse COVID-19 outcomes, possibly due to these patients having more advanced atherosclerosis and target organ damage. Such patients may need to consider adhering to stricter social distancing, to limit the impact of COVID-19 as future waves of the pandemic occur.


Assuntos
Pressão Sanguínea/efeitos dos fármacos , COVID-19/epidemiologia , Hipertensão/epidemiologia , Pandemias , SARS-CoV-2 , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Hipertensivos/uso terapêutico , Aterosclerose/epidemiologia , COVID-19/prevenção & controle , Comorbidade , Inglaterra/epidemiologia , Etnicidade/estatística & dados numéricos , Feminino , Seguimentos , Hospitalização/estatística & dados numéricos , Humanos , Hipertensão/tratamento farmacológico , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Atenção Primária à Saúde/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Análise de Sobrevida , Resultado do Tratamento
2.
Rheumatology (Oxford) ; 59(Suppl 1): i29-i36, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-32159792

RESUMO

PsA is a complex, heterogeneous disease that can place a large burden on patients' psychological and physical well-being. The multifaceted nature of PsA poses a significant assessment challenge, both in randomized control trials and in clinical practice. In recent years, there has been much progress in the development of unidimensional and composite measures of disease activity, as well as of questionnaires that capture the patient's perspective of the condition. Despite these advances, there remains uncertainty around which tools to implement within a research setting. This review aims to summarize the currently available clinical and patient-derived assessment tools, providing a practical and informative resource for the assessment of PsA. This review will also explore recent advancements in digital approaches to the assessment of rheumatological conditions. This will highlight the potential for digitalization in the assessment and monitoring of PsA, outlining innovative means of capturing disease activity and treatment response.


Assuntos
Artrite Psoriásica/tratamento farmacológico , Artrite Psoriásica/psicologia , Informática Médica/instrumentação , Inquéritos e Questionários/estatística & dados numéricos , Artrite/complicações , Artrite Psoriásica/patologia , Efeitos Psicossociais da Doença , Entesopatia/complicações , Humanos , Avaliação de Resultados em Cuidados de Saúde , Medição da Dor/estatística & dados numéricos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Espondiloartropatias/complicações , Telemedicina/métodos
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