Russian Open Medical Journal · Published 2025-09-30 · DOI 10.15275/rusomj.2025.0307
This study aimed to investigate the average daily variability of blood pressure (BP) in normotensive men in relation to COVID-19, its effects on the cardiovascular system, and changes in the chronostructure of the daily BP rhythm following infection. Additionally, the prognostic significance of these factors was evaluated under Arctic rotating shift work conditions. Material and Methods — A one-step retrospective analysis was conducted on the medical records of 517 patients treated at the hospital of the Medical Unit of Gazprom Dobycha Yamburg LLC (Yamburg settlement, Russia; 68°21′40″ N). Among these, 310 patients had confirmed COVID-19. From this cohort, 230 men with arterial hypertension (AH) but normal BP, both with and without COVID-19, were selected. Echocardiography (EchoCG) and ambulatory blood pressure monitoring (ABPM) were performed during the “pre-COVID” period. This study is part of a larger project previously published in RusOMJ (2024; 4). Here, we present results from normotensive men with (n=32) and without COVID-19 (n=32), matched for age and shift work experience. Both groups underwent repeated assessments after 15±3 months. At the hospital, 20.6% of patients with COVID-19 experienced a mild disease course, while 73% experienced a moderate course without complications or fatal outcomes. Lung damage assessed by computed tomography (CT) was classified as type “0” in 23%, type “1” in 29.4%, and type “2” in 34.1% of these patients. Ambulatory blood pressure monitoring (ABPM) was performed using the BPLab v.3.2 device (Russia). Chronobiological analysis of BP and chronotype classification followed the method of Cugini et al. Echocardiography (EchoCG) was performed with a Philips CX50 scanner (Netherlands). Results — Logistic regression analysis revealed that a 1 mm increase in the diameter of the inferior vena cava was associated with a twofold increase in the risk of COVID-19. Similarly, a 1.0 mmHg increase in the average daily variability of diastolic blood pressure (DBP) corresponded to a 1.5-fold increase in risk. The area under the receiver operating characteristic (ROC) curve was 0.785 (p=0.001). Longitudinal follow-up after COVID-19 revealed that 28.1% of normotensive men developed hypertensive average daily BP levels ≥135/85 mmHg. This increase was accompanied by an increased workload on the right side of the heart. Additionally, concentric left ventricular hypertrophy was detected in 25% of these men. A decrease in the “true normotension” chronotype and an increase in hypertensive chronotypes were observed, including 25.6% of participants exhibiting an atypical arterial hypertension (AH) chronotype characterized by short-term rhythms in daily BP (“aperiodic AH”). An inverse relationship was identified between BP variability and the 24-hour rhythm period, which was associated with a 21.5% increased risk of developing this atypical AH chronotype one year after COVID-19 infection. Conclusions — Under Arctic rotating shift work conditions, increased blood pressure (BP) variability serves as an indicator of autonomic dysfunction and a marker of disrupted chronostructure in the daily BP rhythm. These findings have prognostic significance for an elevated risk of COVID-19 and subsequent cardiovascular complications.
Abstract from DOAJ. Public domain (CC0 1.0).
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