Johansson Madeleine, Ståhlberg Marcus, Ricci Fabrizio, Lewinter Christian, Hamrefors Viktor, Nilsson Peter M, Sutton Richard, Fedorowski Artur
Department of Clinical Sciences, Lund University, Malmö, Sweden (M.J., F.R., V.H., P.M.N., A.F.).
Department of Cardiology, Skåne University Hospital, Malmö, Sweden (M.J., V.H.).
Hypertension. 2024 Dec;81(12):2540-2548. doi: 10.1161/HYPERTENSIONAHA.124.23670. Epub 2024 Nov 11.
Postural orthostatic tachycardia syndrome (POTS) is a frequently diagnosed cardiovascular disorder after COVID-19 infection. POTS is characterized by the presence of excessive sinus tachycardia on standing without a fall in blood pressure (BP). We investigated the BP profile using 24-hour ambulatory BP monitoring in patients with new-onset POTS after COVID-19 compared with prepandemic population-based controls.
We performed a case-control study in 100 patients (mean age, 40.0±12.9 years; 85% women) with verified post-COVID-19 new-onset POTS diagnosed by a positive head-up tilt testing versus 100 controls from a population-based cohort with a negative active standing test, no history of syncope, POTS, or endocrine disease (mean age, 42.3±14.0 years; 78% women). Twenty-four-hour BP profile was assessed for circadian BP variation including hypotensive systolic BP (SBP) episodes (<80, <90, and <100 mm Hg).
Patients with post-COVID-19 POTS had significantly higher nighttime SBP, but not daytime SBP, and more daytime SBP hypotensive episodes compared with controls. Nondipping (34% versus 19%; <0.001) and reverse dipping patterns (9% versus 0%; <0.001) were more frequent in post-COVID-19 POTS. In the logistic regression, patients with post-COVID-19 POTS had significantly higher mean 24-hour SBP (odds ratio, 1.08 [95% CI, 1.04-1.11]; <0.001) and nighttime SBP (odds ratio, 1.07 [95% CI, 1.04-1.10]; <0.001), independent of age and sex.
Patients with post-COVID-19 POTS demonstrate higher mean 24-hour and nighttime SBP and show disruptions of circadian BP rhythm regulation compared with population-based controls, as well as more daytime hypotensive episodes. Future studies are needed to test whether patients with post-COVID-19 POTS may benefit from tailored BP therapy.
体位性直立性心动过速综合征（POTS）是新冠病毒感染后经常被诊断出的一种心血管疾病。POTS的特征是站立时窦性心动过速过度，而血压（BP）不下降。我们使用24小时动态血压监测，对新冠病毒感染后新发POTS患者与疫情前基于人群的对照组的血压情况进行了调查。
我们进行了一项病例对照研究，研究对象为100例经证实新冠病毒感染后新发POTS的患者（平均年龄40.0±12.9岁；85%为女性），这些患者通过阳性直立倾斜试验确诊，与100名来自基于人群队列的对照组进行比较，对照组主动站立试验为阴性，无晕厥、POTS或内分泌疾病史（平均年龄42.3±14.0岁；78%为女性）。评估24小时血压情况，以了解昼夜血压变化，包括低血压收缩压（SBP）发作（<80、<90和<100 mmHg）。
与对照组相比，新冠病毒感染后POTS患者夜间SBP显著更高，但白天SBP无差异，且白天SBP低血压发作更多。非勺型血压模式（34%对19%；<0.001）和反勺型血压模式（9%对0%；<0.001）在新冠病毒感染后POTS患者中更常见。在逻辑回归分析中，新冠病毒感染后POTS患者的平均24小时SBP（比值比，1.08 [95% CI，1.04 - 1.11]；<0.001）和夜间SBP（比值比，1.07 [95% CI，1.04 - 1.
