OBJECTIVES: Hypertension, a highly prevalent chronic disease, affects one-third of adults globally and poses a major public health challenge due to subsequent complications such as stroke and heart failure. Despite this, hypertension often remains undetected due to its asymptomatic nature and is therefore referred to as the "silent killer." The prevalence has doubled from 1990 to 2019. Genetic factors, lifestyle choices, and COVID-19 have been linked to increased hypertension risk. Most studies focus on hospitalized patients, overlooking those in primary care.

METHODS: A retrospective population based open exposed – non-exposed cohort study (n= 179,470 patients), from March 1, 2020, to July 31, 2021, was undertaken using THIN® UK data. Eligible adults had a medical history of at least 12 months before and at least 6 months after the index date. Exclusion criteria included pre-existing hypertension or antihypertensive treatment. Patients were categorized into COVID-19 exposed (n=32,582) and non-exposed(n=127,897) groups. The study analyzed the risk of developing hypertension post-COVID-19 infection (between 4 weeks and 6 months after diagnosis), defined by an incident hypertension diagnosis. Data extraction and analysis was facilitated using Dexter®, an epidemiological platform.

RESULTS: The average age of patients was 40 years with a majority being female (59%). Patients exposed to COVID-19 had more than a fourfold increased risk of developing hypertension (adjusted HR=4,01; p<0,001). The estimate remained robust in a sensitivity analysis on a hypertension cohort identified by specific treatment (adjusted HR=3,83; p<0,001)

CONCLUSIONS: These findings provide valuable insights into primary care settings, where most COVID-19 and hypertension treatments are administered. This study demonstrated Dexter®’s effectiveness in rapidly generating evidence.