Covid-19 associated reduction in hypertension-related diagnostic and therapeutic procedures in Excellence Centers of the European Society of Hypertension

Figures & data

Table 1. Study questionnaire.

+ Name participant, name Excellence Centre, country

ABPM

+ Number of ABPM performed 2019

+ Overall

+ January–March 2019, April–June 2019, July–September 2019, October–December 2019

+ Number of ABPM performed 2020

+ Overall

+ January–March 2020, April–June 2020, July–September 2020, October–December 2020

Renal artery duplex ultrasound

+ number of renal artery duplex ultrasound performed 2019

+ overall

+ January–March 2019, April–June 2019, July–September 2019, October–December 2019

+ number of renal artery duplex ultrasound performed 2020

+ overall

+ January–March 2020, April–June 2020, July–September 2020, October–December 2020

Renal artery CT–angiography + MRI–angiography

+ Number of renal artery CT–angiography + MRI–angiography performed 2019

+ Overall

+ January–March 2019, April–June 2019, July–September 2019, October–December 2019

+ Number of renal artery CT–angiography + MRI–angiography performed 2020

+ Overall

+ January–March 2020, April–June 2020, July–September 2020, October–December 2020

Renal artery angioplasty

+ Number of renal artery angioplasty performed 2019

+ Overall

+ January–March 2019, April–June 2019, July–September 2019, October–December 2019

+ Number of renal artery angioplasty performed 2020

+ Overall

+ January–March 2020, April–June 2020, July–September 2020, October–December 2020

Laboratory tests for plasma + urinary catecholamines

+ number of laboratory tests for plasma + urinary catecholamines performed 2019

+ overall

+ January–March 2019, April–June 2019, July–September 2019, October–December 2019

+ number of laboratory tests for plasma + urinary catecholamines performed 2020

+ overall

+ January–March 2020, April–June 2020, July–September 2020, October–December 2020

Laboratory tests for plasma renin and aldosterone

+ Number of laboratory tests for plasma renin and aldosterone performed 2019

+ Overall

+ January–March 2019, April–June 2019, July–September 2019, October–December 2019

+ Number of laboratory tests for plasma renin and aldosterone performed 2020

+ Overall

+ January–March 2020, April–June 2020, July–September 2020, October–December 2020

Figure 1. Reduction in hypertension-related diagnostic tests and one selected therapeutic procedure from 2019 to 2020. Left side: overall, right side: in 3-month intervals. ABPM: ambulatory blood pressure monitoring; Duplex RA: duplex ultrasound investigations of renal arteries; CT/MRI RA: computed tomographic/magnetic resonance imaging angiography of renal arteries; PTA RA: percutaneous angioplasties of renal arteries.

Table 2. Hypertension-related diagnostic tests and one selected therapeutic procedure 2019 and 2020.

Diagnostic test	Participating centres overall/3 months intervals	2019					2020
		Overall	Jan–Mar	Apr–Jun	Jul–Sep	Oct–Dec	Overall	Jan–Mar	Apr–Jun	Jul–Sep	Oct–Dec
ABPM	53/50	544*	152^#	140^#	96^$	152^#	289	106	47	57.5	78.5
		[237–1016]	[67–293]	[60.5–275]	[48–170]	[53.5–272]	[143–598]	[43–220]	[21.5–116]	[27–126]	[37–162]
Duplex RA	46/42	88.5*	30^#	29^#	24.5^#	27.5^#	55	25.5	11.5	10.5	16
		[52–312]	[14–80]	[15–76]	[15–69]	[13–82]	[35–205]	[14–64]	[2–33]	[6–45]	[5–44]
CT/MRI RA	42/38	66*	21.5^$	18^#	15	18.5^$	19.5	12	6	6	8
		[10–170]	[5–40]	[2–46.3]	[2–37]	[3–48]	[5–120]	[2–41]	[0.25–30]	[0–30]	[1–31]
Angioplasty RA	45/38	5*	2^§	2^&	1	1^#	1	0	0	0	0
		[1–11.5]	[0–4]	[0–4.75]	[0–2.75]	[0–4]	[0–8.25]	[0–3]	[0–2]	[0–2]	[0–2]
Catecholamines	46/41	116*	36.5^$	40^#	29	39^#	67.5	29.5	15	15	18
		[35–299]	[10–82]	[8.25–81.8]	[8–69.3]	[10–90]	[17–232]	[5–64]	[3.25–39.8]	[3.75–56]	[4.75–65.3]
Renin/Aldosterone	45/42	146*	43.5^#	47^#	37	45	83.5	25	17	26	21
		[59.5–448]	[15–153]	[11–107]	[12–92.8]	[14–97.5]	[33–309]	[9.5–93]	[4.5–84.3]	[6–90]	[7–82.5]

Values are medians [interquartile range].

*p < 0.001 (Wilcoxon test for paired samples) for comparison of overall numbers 2019 versus 2020.

^#p < 0.001; ^$p = 0.005; ^&p = 0.002; ^§p = 0.01; all comparisons between respective 3 time intervals 2019 versus 2020 are calculated with Wilcoxon’s test for paired samples, with Bonferroni correction.

ABPM: ambulatory blood pressure monitoring; Duplex RA: duplex ultrasound investigations of renal arteries; CT/MRI RA: computed tomographic/magnetic resonance imaging angiography of renal arteries.

Table 3. Changes expressed as percentage [interquartile range] in hypertension-related diagnostic tests and one selected therapeutic procedure from 2019 to 2020.

Diagnostic test	Participating centres overall/3-month intervals	Overall	Jan–Mar	Apr–Jun	Jul–Sep	Oct–Dec	p-Value (Friedman)	Significant pairwise comparisons (post-hoc)*	p-Value, post hoc correlation
ABPM	49	−30.8	−18.8	−50.7	−25	−33.3	<0.001	(1…2)(1…4)(2…3)(2…4)	<0.001, 0.03, <0.001, 0.003
		[−48.4, −17.7]	[−30.6, 0]	[−76.3, −32.8]	[−49.1, 1.18]	[−55.8, −12.4]
Duplex RA	39	−33.3	−20.2	−47.1	−33.8	−41	<0.001	(1…2)(1…4)	<0.001, 0.02
		[−45.5, −24]	[−36.1, −3.03]	[−70.7, −31.2]	[−50, −15.9]	[−60.9, −15.7]
CT/MRI RA	34	−35.1	−24.1	−50	−13.7	−31.8	0.002	(1…2)(2…3)	0.05, 0.05
		[−52.2, −11.1]	[−45.5, −6.67]	[−85.7, −29.4]	[−70, 7.41]	[−66.7, 0]
Angioplasty RA	17	−38.9	−25	−57.1	−50	−66.7	0.01	(1…2)(1…4)	0.009, 0.02
		[−60, −26.7]	[−51.6, 0]	[−100, −50]	[−100, 9.38]	[−100, −45.8]
Catecholamines	37	−31.7	−27.8	−46.9	−14.3	−28.9	<0.001	(1…2)(2…3)(2…4)	0.002, <0.001, 0.007
		[−50.3, −11.9]	[−40.1, −6.67]	[−79.5, −28.8]	[−50, 11.6]	[−58.8, −11.8]
Renin/Aldosterone	38	−29.7	−26.3	−41	−15.1	−26.2	0.001	(1…2)(2…3)(2…4)	0.006, 0.005, 0.03
		[−57.4, −11.5]	[−49, −6.25]	[−67.1, −25]	[−54.5, 18.2]	[−71.4, 10.7]

p-Values were calculated with Friedman test to detect overall differences in reduction between 3-month time intervals; post-hoc analyses using Wilcoxon`s test for paired samples with Bonferroni correction was performed for pairwise comparison of reduction between 3-month time intervals.

*1: Jan–Mar; 2: Apr–Jun; 3: Jul–Sep; 4: Oct–Dec.

ABPM: ambulatory blood pressure monitoring; Duplex RA: duplex ultrasound investigations of renal arteries; CT/MRI RA: computed tomographic/magnetic resonance imaging angiography of renal arteries.