Teymourzadeh Azin, Abramov Dmitry, Norouzi Sayna, Grewal Dennis, Heidari-Bateni Giv
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States.
Division of Cardiology, Department of Medicine, Loma Linda University Medical Center, Loma Linda, CA, United States.
Front Cardiovasc Med. 2025 Aug 18;12:1609768. doi: 10.3389/fcvm.2025.1609768. eCollection 2025.
Post-COVID new-onset hypertension (PCNH) is an increasingly reported complication among COVID-19 survivors. PCNH can emerge up to 12 months postinfection, with elevated risks observed among older patients, particularly those who experienced severe COVID-19, and among females, implicating the possibility of age and hormonal influence. Leading theories converge on enduring dysregulation of the angiotensin pathway and endothelial dysfunction. In addition to renin-angiotensin alterations, sustained inflammation, lung vascular damage, deconditioning, and mental health decline may also impact the likelihood of PCNH. Conventional renin-angiotensin system (RAS) antagonists may help improve pathway distortions, while novel anti-inflammatory agents and recombinant ACE2 biologics can help mitigate endothelial injury to alleviate cardiovascular burden. This review highlights the multifaceted mechanisms driving PCNH and the need to elucidate timing, predictors, pathophysiology, and tailored interventions to address this parallel pandemic among COVID-19 survivors.
新冠后新发高血压（PCNH）是新冠病毒感染幸存者中报告日益增多的一种并发症。PCNH可在感染后长达12个月出现，在老年患者中风险升高，尤其是那些经历过重症新冠病毒感染的患者，以及女性患者，这暗示了年龄和激素影响的可能性。主要理论集中在血管紧张素途径的持续失调和内皮功能障碍。除了肾素 - 血管紧张素改变外，持续炎症、肺血管损伤、身体机能下降和心理健康衰退也可能影响PCNH的发生可能性。传统的肾素 - 血管紧张素系统（RAS）拮抗剂可能有助于改善途径扭曲，而新型抗炎药和重组ACE2生物制剂可帮助减轻内皮损伤以减轻心血管负担。本综述强调了驱动PCNH的多方面机制，以及阐明时间、预测因素、病理生理学和针对性干预措施以应对新冠病毒感染幸存者中这一并发大流行的必要性。
