Association between equivalized annual household income and regular medical visits for hypertensive patients since the COVID-19 outbreak.

Previous studies have shown an increase in blood pressure during the coronavirus disease 2019 (COVID-19) pandemic even among patients receiving antihypertensive treatment. This study aims to evaluate the association between equivalized annual household income and refraining from regular medical visits for hypertensive patients since the COVID-19 outbreak. We analyzed data from the Japan COVID-19 and Society Internet Survey (JACSIS), including 2832 hypertensive patients aged 20-79 years from the 2020 survey and at least one survey between 2021 and 2023. They were categorized into lower-income (<median of ¥3,182,000) and higher-income (≥median) groups. Refraining from regular medical visits was defined as not attending scheduled medical visits for hypertension in the past two months. Poisson regression or generalized linear mixed models were used, inverse probability weighted for Internet survey selection. After weighting, the mean age was 64.8 ± 10.3 years and 63.7% were men. In 2020, the proportion of hypertensive patients refraining from regular medical visits after weighting was 19.6% in the lower-income group and 8.8% in the higher-income group, with an adjusted proportion ratio (95% confidence interval) of 1.86 (1.13-3.06) for the lower-income group compared with the higher-income group. After 2020, the proportion of those refraining from regular medical visits declined in all income groups, and the income-related differences disappeared. During the social restrictions due to the COVID-19 pandemic, hypertensive patients with lower equivalized annual household incomes were more likely to refrain from regular medical visits. Strategies to reduce income-related inequities in medical care utilization may be necessary for future public health crises. A nationwide Internet survey in Japan revealed hypertensive patients with lower equivalized annual household incomes were significantly more likely to refrain from regular medical visits in 2020, during the social restrictions due to the COVID-19 pandemic. Addressing income-related inequities in medical care utilization is crucial for future public health crises.