Abstract P266: Hypertensive Response In Recently Covid-19 Vaccinated Patients

Background: A non-immediate hypertensive response after COVID-19 vaccination has been reported. Mild to moderate elevated arterial blood pressure (BP) levels have been documented a few days after a single or two-doses vaccine. This study sought to investigate this observation as a potential side effect in patients with known hypertension and healthy controls. Methods: Overall 60 vaccinated patients between the age of 50 to 70 years old were studied. They were randomly assigned to one of the approved and available vaccines (Pfizer, Astra Zeneca or Moderna) twice within a month. Half of them were hypertensives under medical treatment and half of them were not.All participants volunteered for standard daily home blood pressure measurements (HBPM) and had also ambulatory blood pressure measurements (ABPM) between the 1 st and the 30 th day after the second dose of COVID-19 vaccine. Results: All patients, hypertensives or not, had at some point a recorded and substantial hypertensive response for both systolic (SBP) and diastolic (DBP) blood pressure after the second dose of the vaccine. Hypertensives were older and with higher body mass index (BMI). Some of the hypertensive patients received additional medication whereas some of the non-hypertensive patients started life modification changes and systematic BP measurements for a possible diagnosis of hypertension. Conclusions: Vaccination for COVID 19 seems to be related with a short period of hypertensive response. This phenomenon was partial and mostly observed in older overweight hypertensives.

Comparison of ESHG2016 and AAP2017 hypertension guidelines in adolescents between the ages of 13 and 16: effect of body mass index on guidelines

Objective: The diagnosis of hypertension in adolescents aged ≥13 and <16 years is based on the percentile according to age, gender, and height in the European Society of Hypertension guidelines guideline; whereas, the American Academy of Pediatrics guideline uses blood pressure above 130/80 mmHg as a single criterion. Therefore, this study aimed to evaluate the compatibility of these two guidelines in adolescents aged ≥13 and <16 years. Methods: This study was designed by retrospectively screening the records of 395 adolescents with both office and 24-hour ambulatory blood pressure measurements. Each blood pressure measurement was classified according to both the ESGH2016 and AAP2017 guidelines. Patients were divided into three subgroups according to body mass index. Cohen’s kappa analysis was used to evaluate the agreement between the two guidelines. Results: The majority of adolescents were normotensive according to both guidelines, 55.9% by ESHG2016 and 43.1% by AAP2017. For the whole group, the frequency of hypertension was 32.4% with ESHG2016 and 34.4% with AAP2017; while, in obese patients, hypertension frequencies were 38.8% and 43.3%, respectively. The diagnosis of hypertension was demonstrated with the two guidelines, and there was significant agreement at a substantial level, both for the obese subgroup and the whole study group (kappa value = 0.738 and 0.785, respectively). The frequency of white-coat hypertension was higher with the AAP2017 guideline (28.1% versus 16.2%, p < 0.001). Conclusion: With our experience in this single-centre study, it seems that both the AAP2017 and the ESHG2016 guidelines can be used in the diagnosis of hypertension in adolescents.

Normal Variations in Blood Pressure in Ambulatory Blood Pressure Measurements

Aim: Hypertension is very common in primary care patients. The diagnosis of hypertension is made by office measurements and home blood pressure measurements. The aim of this study was to define the normal variation levels of blood pressure in individuals in primary care by using ambulatory blood pressure measurement. Methods: This study was performed in primary care. Individuals who had no hypertension history were included in the study. Subjects were evaluated by using three office measurements, seven days home blood pressure measurements and 24 hours ambulatory blood pressure measurement. The ambulatory blood pressure gave us the variations in blood pressure values. Results: The study started in January 2018 and ended in May 2018. Of the 47 subjects, 70.2% were women and 29.8% were men. The mean age was 41.63±12.00. The most common educational level was elementary school graduates. The most common occupation was housewives. Of the participants, 84.2% were married. At ambulatory blood pressure measurements, 34.0% of the subjects had mean systolic blood pressures 24 hours between 120-129 mmHg. Of the diastolic blood pressure 24 hours mean values, 15.3% had values between 80-89, where 51.0% were between the 71-79 mmHg groups. The mean value of 24 hours variation in systolic blood pressure was 15.75±18.59 (median=11.40, min=8.80, max=106.00). The 24 hours variation in the mean values of diastolic blood pressures was 12.12±10.90 (median=9.70, min=6.80, max=64.00). Conclusion: The results of this study demonstrated that there were high levels of variations in normal blood pressures, which could show candidates for hypertension. Keywords: ambulatory monitoring, blood pressure, variability, primary care