Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ASCO Annual Meeting 2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

2024 ASCO Annual Meeting

Keep up to date with all the top stories and latest evidence with our hub page, including official congress videos and expert takeaways.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | COVID-19 | Research

Habitual salt preference worsens blood pressure in hospitalized hypertensive patients with omicron infection under epidemic-related stress

Authors: Chenyi Wang, Wanhong Tan, Xiaoxiao Liu, Miao He, Shi Zeng, Maojie Sun, Lijuan Yan, Min Li, Kun Zhan, Kaifa Wang, Qiang Li

Published in: BMC Public Health | Issue 1/2024

Login to get access

Abstract

Background

We investigated the synergistic effect of stress and habitual salt preference (SP) on blood pressure (BP) in the hospitalized Omicron-infected patients.

Methods

From 15,185 hospitalized Omicron-infected patients who reported having high BP or hypertension, we recruited 662 patients. All patients completed an electronic questionnaire on diet and stress, and were required to complete morning BP monitoring at least three times.

Results

The hypertensive group (n = 309) had higher habitual SP (P = 0.015) and COVID-19 related stress (P < 0.001), and had longer hospital stays (7.4 ± 1.5 days vs. 7.2 ± 0.5 days, P = 0.019) compared with controls (n = 353). After adjusting for a wide range of covariates including Omicron epidemic-related stress, habitual SP was found to increase both systolic (4.9 [95% confidence interval (CI), 2.3–7.4] mmHg, P < 0.001) and diastolic (2.1 [95%CI, 0.6–3.6] mmHg, P = 0.006) BP in hypertensive patients, and increase diastolic BP (2.0 [95%CI, 0.2–3.7] mmHg, P = 0.026) in the control group. 31 (8.8%) patients without a history of hypertension were discovered to have elevated BP during hospitalization, and stress was shown to be different in those patients (P < 0.001). In contrast, habitual SP was more common in hypertensive patients with uncontrolled BP, compared with patients with controlled BP (P = 0.002).

Conclusions

Habitual SP and psychosocial stress were associated with higher BP in Omicron-infected patients both with and without hypertension. Nonpharmaceutical intervention including dietary guidance and psychiatric therapy are crucial for BP control during the long COVID-19 period.
Literature
1.
Wolter N, Jassat W, Walaza S, Welch R, Moultrie H, Groome M, Amoako DG, Everatt J, Bhiman JN, Scheepers C, Tebeila N, Chiwandire N, du Plessis M, Govender N, Ismail A, Glass A, Mlisana K, Stevens W, Treurnicht FK, Makatini Z, Hsiao NY, Parboosing R, Wadula J, Hussey H, Davies MA, Boulle A. Von Gottberg A and Cohen C. Early assessment of the clinical severity of the SARS-CoV-2 omicron variant in South Africa: a data linkage study. Lancet. 2022;399:437–46.PubMedPubMedCentralCrossRef
2.
Maslo C, Friedland R, Toubkin M, Laubscher A, Akaloo T, Kama B. Characteristics and outcomes of hospitalized patients in South Africa during the COVID-19 Omicron Wave compared with previous waves. JAMA. 2022;327:583–4.PubMedCrossRef
3.
Cheung PH, Chan CP, Jin DY. Lessons learned from the fifth wave of COVID-19 in Hong Kong in early 2022. Emerg Microbes Infections. 2022;11:1072–8.CrossRef
4.
Li X, Zhong X, Wang Y, Zeng X, Luo T, Liu Q. Clinical determinants of the severity of COVID-19: a systematic review and meta-analysis. PLoS ONE. 2021;16:e0250602.PubMedPubMedCentralCrossRef
5.
Shu L, Wang X, Li M, Chen X, Ji N, Shi L, Wu M, Deng K, Wei J, Wang X, Cao Y, Yan J, Feng G. Clinical characteristics of moderate COVID-19 patients aggravation in Wuhan Stadium Cabin Hospital: a 571 cases of retrospective cohort study. J Med Virol. 2021;93:1133–40.PubMedCrossRef
6.
7.
Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? The Lancet Respiratory Medicine. 2020;8:e21.PubMedPubMedCentralCrossRef
8.
Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DSC, Du B, Li LJ, Zeng G, Yuen KY, Chen RC, Tang CL, Wang T, Chen PY, Xiang J, Li SY, Wang JL, Liang ZJ, Peng YX, Wei L, Liu Y, Hu YH, Peng P, Wang JM, Liu JY, Chen Z, Li G, Zheng ZJ, Qiu SQ, Luo J, Ye CJ, Zhu SY, Zhong NS, China Medical Treatment Expert Group for C. Clinical characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382:1708–20.PubMedCrossRef
9.
Lippi G, Wong J, Henry BM. Hypertension in patients with coronavirus disease 2019 (COVID-19): a pooled analysis. Pol Archives Intern Med. 2020;130:304–9.
10.
Sheppard JP, Nicholson BD, Lee J, McGagh D, Sherlock J, Koshiaris C, Oke J, Jones NR, Hinton W, Armitage L, Van Hecke O, Lay-Flurrie S, Bankhead CR, Liyanage H, Williams J, Ferreira F, Feher MD, Ashworth AJ, Joy MP, de Lusignan S, Hobbs FDR. Association between Blood Pressure Control and coronavirus disease 2019 outcomes in 45 418 symptomatic patients with hypertension: an Observational Cohort Study. Hypertension. 2021;77:846–55.PubMedCrossRef
11.
Endo K, Miki T, Itoh T, Kubo H, Ito R, Ohno K, Hotta H, Kato N, Matsumoto T, Kitamura A, Tamayama M, Wataya T, Yamaya A, Ishikawa R, Ooiwa H. Impact of the COVID-19 pandemic on Glycemic Control and blood pressure control in patients with diabetes in Japan. Intern Med. 2022;61:37–48.PubMedPubMedCentralCrossRef
12.
Qiu J, Shen B, Zhao M, Wang Z, Xie B, Xu Y. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. Gen Psychiatry. 2020;33:e100213.CrossRef
13.
Dingess PM, Thakar A, Zhang Z, Flynn FW, Brown TE. High-salt exposure during Perinatal Development enhances stress sensitivity. Dev Neurobiol. 2018;78:1131–45.PubMedPubMedCentralCrossRef
14.
Gilman TL, Mitchell NC, Daws LC, Toney GM. Neuroinflammation contributes to high salt intake-augmented neuronal activation and active coping responses to acute stress. Int J Neuropsychopharmacol. 2019;22:137–42.PubMedCrossRef
15.
Laffin LJ, Kaufman HW, Chen Z, Niles JK, Arellano AR, Bare LA, Hazen SL. Rise in blood pressure observed among US adults during the COVID-19 pandemic. Circulation. 2022;145:235–7.PubMedCrossRef
16.
Yilmaz C, Gokmen V. Neuroactive compounds in foods: occurrence, mechanism and potential health effects. Food Res Int. 2020;128:108744.PubMedCrossRef
17.
Rolland B, Haesebaert F, Zante E, Benyamina A, Haesebaert J, Franck N. Global Changes and Factors of Increase in Caloric/Salty Food Intake, screen use, and Substance Use during the early COVID-19 Containment Phase in the General Population in France: Survey Study. JMIR Public Health and Surveillance. 2020;6:e19630.PubMedPubMedCentralCrossRef
18.
Zhang X, Chen B, Jia P, Han J. Locked on salt? Excessive consumption of high-sodium foods during COVID-19 presents an underappreciated public health risk: a review. Environ Chem Lett. 2021;19:3583–95.PubMedPubMedCentralCrossRef
19.
Oliveira-Maia AJ, Roberts CD, Simon SA, Nicolelis MA. Gustatory and reward brain circuits in the control of food intake. Adv Tech Stand Neurosurg. 2011;36:31–59.PubMedPubMedCentralCrossRef
20.
Batis C, Gordon-Larsen P, Cole SR, Du S, Zhang B, Popkin B. Sodium intake from various time frames and incident hypertension among Chinese adults. Epidemiology. 2013;24:410–8.PubMedPubMedCentralCrossRef
21.
He J, Huang JF, Li C, Chen J, Lu X, Chen JC, He H, Li JX, Cao J, Chen CS, Bazzano LA, Hu D, Kelly TN, Gu DF. Sodium Sensitivity, Sodium Resistance, and incidence of hypertension: a Longitudinal Follow-Up study of Dietary Sodium intervention. Hypertension. 2021;78:155–64.PubMedCrossRef
22.
Li Q, Cui Y, Jin R, Lang H, Yu H, Sun F, He C, Ma T, Li Y, Zhou X, Liu D, Jia H, Chen X, Zhu Z. Enjoyment of Spicy Flavor enhances central salty-taste perception and reduces salt intake and blood pressure. Hypertension. 2017;70:1291–9.PubMedCrossRef
23.
2018 Chinese guidelines for the management of hypertension. Chin J Cardiovasc Med. 2019.
24.
Li Q, Li Q, Sun F, Yan G, Lang H, Zhu Z. Enhancement of Orbitofrontal and Insular cortices responses to Spicy Perception increases high Salt sensation: an event–related potentials study. Heart Mind. 2019; 3.
25.
Dobkin RD, Mann SL, Gara MA, Interian A, Rodriguez KM, Menza M. Telephone-based cognitive behavioral therapy for depression in Parkinson disease: a randomized controlled trial. Neurology. 2020;94:e1764–73.PubMedPubMedCentralCrossRef
26.
Turner AI, Smyth N, Hall SJ, Torres SJ, Hussein M, Jayasinghe SU, Ball K, Clow AJ. Psychological stress reactivity and future health and disease outcomes: a systematic review of prospective evidence. Psychoneuroendocrinology. 2020;114:104599.PubMedCrossRef
27.
Chrousos GP. Stress and disorders of the stress system. Nat Reviews Endocrinol. 2009;5:374–81.CrossRef
28.
Murakami N, Hayden R, Hills T, Al-Samkari H, Casey J, Del Sorbo L, Lawler PR, Sise ME, Leaf DE. Therapeutic advances in COVID-19. Nat Rev Nephrol. 2023;19(1):38–52.PubMedCrossRef
29.
30.
He FJ, Tan M, Ma Y, MacGregor GA. Salt reduction to prevent hypertension and Cardiovascular Disease: JACC State-of-the-art review. J Am Coll Cardiol. 2020;75:632–47.PubMedCrossRef
31.
Garfinkle MA. Salt and essential hypertension: pathophysiology and implications for treatment. J Am Soc Hypertension: JASH. 2017;11:385–91.PubMedCrossRef
32.
Mutchler SM, Kirabo A, Kleyman TR. Epithelial Sodium Channel and Salt-Sensitive Hypertension. Hypertension. 2021;77(3):759–67.PubMedCrossRef
33.
Pearce L, Davidson SM, Yellon DM. The cytokine storm of COVID-19: a spotlight on prevention and protection. Expert Opin Ther Targets. 2020;24(8):723–30.PubMedCrossRef
34.
Cárdenas-Rodríguez N, Bandala C, Vanoye-Carlo A, Ignacio-Mejía I, Gómez-Manzo S, Hernández-Cruz EY, Pedraza-Chaverri J, Carmona-Aparicio L, Hernández-Ochoa B. Use of antioxidants for the Neuro-Therapeutic Management of COVID-19. Antioxid (Basel). 2021;10(6):971.CrossRef
35.
Fodor A, Tiperciuc B, Login C, Orasan OH, Lazar AL, Buchman C, Hanghicel P, Sitar-Taut A, Suharoschi R, Vulturar R, Cozma A. Endothelial dysfunction, inflammation, and oxidative stress in COVID-19-Mechanisms and therapeutic targets. Oxid Med Cell Longev. 2021;2021:8671713.PubMedPubMedCentralCrossRef
36.
Zhang X, Chen B, Jia P, Han J. Locked on salt? Excessive consumption of high-sodium foods during COVID-19 presents an underappreciated public health risk: a review. Environ Chem Lett. 2021;19(5):3583–95.PubMedPubMedCentralCrossRef
37.
Russo SJ, Nestler EJ. The brain reward circuitry in mood disorders. Nat Rev Neurosci. 2013;14:609–25.PubMedCrossRef
38.
Mitchell NC, Gilman TL, Daws LC, Toney GM. High salt intake enhances swim stress-induced PVN vasopressin cell activation and active stress coping. Psychoneuroendocrinology. 2018;93:29–38.PubMedPubMedCentralCrossRef
39.
Kobayashi K, Chin K, Umezawa S, Ito S, Yamamoto H, Nakano S, Takada N, Hatori N, Tamura K. Influence of stress induced by the first announced state of emergency due to coronavirus disease 2019 on outpatient blood pressure management in Japan. Hypertens Research: Official J Japanese Soc Hypertens. 2022;45:675–85.CrossRef
40.
Ito S, Kobayashi K, Chin K, Umezawa S, Yamamoto H, Nakano S, Takada N, Hatori N, Tamura K. Impact of the first announced state of emergency owing to coronavirus disease 2019 on stress and blood pressure levels among patients with type 2 diabetes mellitus in Japan. J Diabetes Invest. 2022;13:1607–16.CrossRef
41.
Hackett RA, Steptoe A. Type 2 diabetes mellitus and psychological stress - a modifiable risk factor. Nat Reviews Endocrinol. 2017;13:547–60.CrossRef
42.
Ali S, Stone MA, Peters JL, Davies MJ, Khunti K. The prevalence of co-morbid depression in adults with type 2 diabetes: a systematic review and meta-analysis. Diabet Medicine: J Br Diabet Association. 2006;23:1165–73.CrossRef
43.
Smith KJ, Beland M, Clyde M, Gariepy G, Page V, Badawi G, Rabasa-Lhoret R. And Schmitz N. Association of diabetes with anxiety: a systematic review and meta-analysis. J Psychosom Res. 2013;74:89–99.PubMedCrossRef
44.
Saito K, Kim JI, Maekawa K, Ikeda Y, Yokoyama M. The great Hanshin-Awaji earthquake aggravates blood pressure control in treated hypertensive patients. Am J Hypertens. 1997;10:217–21.PubMedCrossRef
45.
Celik M, Yilmaz Y, Karagoz A, Kahyaoglu M, Cakmak EO, Kup A, Celik FB, Karaduman A, Kulahcioglu S, Izci S, Gecmen C, Caliskan M. Anxiety disorder Associated with the COVID-19 pandemic causes deterioration of blood pressure control in primary hypertensive patients. Medeniyet Med J. 2021;36:83–90.
46.
Pengo MF, Albini F, Guglielmi G, Mollica C, Soranna D, Zambra G, Zambon A, Bilo G, Parati G. Home blood pressure during COVID-19-related lockdown in patients with hypertension. Eur J Prev Cardiol. 2022;29:e94–6.PubMedCrossRef
47.
Feitosa F, Feitosa ADM, Paiva AMG, Mota-Gomes MA, Barroso WS, Miranda RD, Barbosa ECD, Brandao AA, Lima-Filho JL, Sposito AC, Coca A, Nadruz W Jr. Impact of the COVID-19 pandemic on blood pressure control: a nationwide home blood pressure monitoring study. Hypertens Research: Official J Japanese Soc Hypertens. 2022;45:364–8.CrossRef
48.
Han J, Zhang X, He S, Jia P. Can the coronavirus disease be transmitted from food? A review of evidence, risks, policies and knowledge gaps. Environ Chem Lett. 2021;19:5–16.PubMedCrossRef
49.
Abdul Rahman H, Julaini NN, Zaim SNN, Masri NA, Abdul-Mumin KH. Mental Wellbeing and Health-Risk behaviours of University students in Brunei: a cross-sectional study during COVID-19 pandemic. Healthc (Basel). 2023;11(16):2327.
50.
Rahman HA, Amornsriwatanakul A, Abdul-Mumin KH, Agustiningsih D, Chaiyasong S, Chia M, Chupradit S, Huy LQ, Ivanovitch K, Nurmala I, Majid HBA, Nazan AINM, Rodjarkpai Y, de la Cruz MHTO, Mahmudiono T, Sriboonma K, Sudnongbua S, Vidiawati D, Wattanapisit A, Charoenwattana S, Cahyani N, Car J, Ho MR, Rosenberg M. Prevalence of Health-Risk behaviors and Mental Well-Being of ASEAN University students in COVID-19 pandemic. Int J Environ Res Public Health. 2022;19(14):8528.PubMedPubMedCentralCrossRef
51.
Singh SA, Dhanasekaran D, Ganamurali N, Sabarathinam LP. Junk food-induced obesity- a growing threat to youngsters during the pandemic. Obes Med. 2021;26:100364.CrossRef
52.
Chinese Preventive Medicine Association. Chinese guideline on healthy lifestyle to prevent cardiometabolic diseases. Chin J Prev Med. 2020;54(3):256–77.
53.
Chinese Society of Cardiology. Chinese experts consensus on diagnosis and management of salt-sensitive hypertension. Chin J Cardiol. 2023;51(4):364–76.
54.
Vaillant MF, Alligier M, Baclet N, Capelle J, Dousseaux MP, Eyraud E, Fayemendy P, Flori N, Guex E, Hennequin V, Lavandier F, Martineau C, Morin MC, Mokaddem F, Parmentier I, Rossi-Pacini F, Soriano G, Verdier E, Zeanandin G, Quilliot D. Guidelines on standard and therapeutic diets for adults in hospitals by the French Association of Nutritionist Dieticians (AFDN) and the French Speaking Society of Clinical Nutrition and Metabolism (SFNCM). Nutrients. 2021;13(7):2434.PubMedPubMedCentralCrossRef
Metadata
Title
Habitual salt preference worsens blood pressure in hospitalized hypertensive patients with omicron infection under epidemic-related stress
Authors
Chenyi Wang
Wanhong Tan
Xiaoxiao Liu
Miao He
Shi Zeng
Maojie Sun
Lijuan Yan
Min Li
Kun Zhan
Kaifa Wang
Qiang Li
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-023-17633-0

Other articles of this Issue 1/2024

BMC Public Health 1/2024 Go to the issue

Research

Exploring information needs among family caregivers of children with intellectual disability in a rural area of South Africa: a qualitative study

Research

Cigarette smoking and cardiovascular disease incidence and all-cause mortality: the modifying role of diet quality

Research

Facilitator experiences and lessons learned from the Betel nut intervention trial (BENIT)

Research

Long-term effects of climate factors on dengue fever over a 40-year period

Research

Marginalisation and distrust in the context of the COVID-19 vaccination programme: experiences of communities in a northern UK city region

Research

Prevalence of prediabetes and risk of CVD mortality in individuals with prediabetes alone or plus hypertension in Northeast China: insight from a population based cohort study