LAUSR

Dear Editor, I have some comments regarding the interesting article entitled “Does COVID-19 Cause Hypertension?”. So far, there is not much evidence as to whether COVID-19 can cause high blood pressure (BP) in previously normotensive patients. Li et al reported that the prevalence of hypertension in patients with COVID-19 was 17.1%. It would be of interest to consider some points regarding this study. Firstly, BP measurements were carried out in a hospital setting using a sphygmomanometer. Despite precautions for obtaining valid measurements, this can cause white coat hypertension. Recent guidelines suggest that BP should initially be measured in both arms, using an appropriate cuff size. The author only used the right arm and a sphygmomanometer was used; semiautomatic or automatic sphygmomanometers could have been a better option in these patients. The author excluded patients on steroid therapy before the start of the study. Most patients in this study received chloroquine/hydroxychloroquine and favipiravir treatment. Although there is not much evidence whether these drugs alter the BP, studies which were mostly conducted on the animals showed that chloroquine might lower BP. Furthermore, a study showed that a single high dose of chloroquine could reduce BP in young adults. The authors suggested that the hypotensive effect could at least in part be attributed to the vasodilatory effect of chloroquine. Analysis involving confounding factors could be more suitable to define the predictive value of COVID-19 regarding the development of hypertension. ORCID iD