FEATURES OF THE DIURNAL PROFILE OF BLOOD PRESSURE AND REMODELING OF THE HEART AND VESSELS IN PEOPLE WITH COVID-19
DOI:
https://doi.org/10.32345/USMYJ.3(164).2026.41-50Keywords:
Arterial hypertension, Blood pressure, COVID-19, Arterial stiffness, Hypertension-mediated organ damageAbstract
Introduction. The relevance of the study is due to the significant prevalence of COVID-19 and its cardiovascular complications worldwide.
Aim. The aim of the work is to assess the features of the processes of heart and vascular remodeling in different types of daily blood pressure profile after a coronavirus infection.
Materials and methods. 100 people were examined in outpatient settings 1 month after COVID-19 (62 men and 38 women), aged 63.14 ± 2.24 years. All examined participants underwent Doppler echocardiography, ultrasound examination of the brachiocephalic arteries, and daily blood pressure monitoring. Methods of primary statistical analysis were used to evaluate the results of the study.
Results. Left ventricular hypertrophy and IMС were diagnosed in 75.0 and 52.0% of patients; in 31.0% – non-dipper daily BP profile, in 14.0% – night-peaker, in 46.0% – dipper, in 9.0% – over-dipper. With LV hypertrophy and its normal geometry, the non-dipper daily BP profile was determined in 33.3 and 24.0%, an increase in IMС – in 45.2 and 6.4% of the examined. In 31.2% of people with eccentric hypertrophy, in 30.7% with concentric hypertrophy, in 29.4% with concentric remodeling, a non-dipper BP profile was detected. With LV hypertrophy and without it, the night-peaker daily BP profile was determined in 14.6 and 12.0% of cases. In 15.6% of those examined after COVID-19 with eccentric hypertrophy, in 11.5% with concentric hypertrophy, in 11.7% with concentric remodeling, a night-peaker BP profile was detected.
Conclusions. The results obtained indicate a significant impact of COVID-19 on the processes of cardiovascular remodeling, indicate the need to include daily BP monitoring, Doppler echocardiography, and vascular ultrasound in the algorithm for diagnosing and treating people with COVID-19.
References
1. Mokhtari T, Hassani F, Ghaffari N, Ebrahimi B, Yarahmadi A, Hassanzadeh G. COVID-19 and multiorgan failure: A narrative review on potential mechanisms. J Mol Histol. 2020 Dec;51(6):613-628. https://doi.org/10.1007/s10735-020-09915-3.
2. Babicki M, Kapusta J, Kołat D, Kałuzińska-Kołat Ż, Mastalerz-Migas A, Jankowski P, Chudzik M. Cardiac symptoms in patients 3-6 months after contracting COVID-19- data from the polish STOP-COVID registry. BMC Infect Dis. 2025 Apr 9;25(1):489. https://doi.org/10.1186/s12879-025-10774-0.
3. Cicco S, Vacca A, Albanese F, Susca N, Desantis V, Magistro A, Cazzato G, Cicco G, Sablone S, Cariddi C, Marozzi MS, Catena C, Brosolo G, Marcante S, Ingravallo G, Dalfino L, Lauletta G, Pappagallo F, Solimando AG, Grasso S, Maiorano E, Introna F, Sechi LA, Ria R. Immune disturbance leads to pulmonary embolism in COVID-19 more than classical risk factors: a clinical and histological study. Intern Emerg Med. 2023 Oct;18(7):1981-1993. https://doi.org/10.1007/s11739-023-03383-9.
4. Xue Y, Sun S, Cai J, Zeng L, Wang S, Wang S, Li J, Sun L, Huo J. Effects of ACEI and ARB on COVID-19 patients: A meta-analysis. J Renin Angiotensin Aldosterone Syst. 2020 Oct-Dec;21(4):1470320320981321. https://doi.org/10.1177/1470320320981321.
5. Cicco S, Vacca A, Cittadini A, Marra AM. Long-Term Follow-Up May be Useful in Coronavirus Disease 2019 Survivors to Prevent Chronic Complications. Infect Chemother. 2020 Sep;52(3):407-409. https://doi.org/10.3947/ic.2020.52.3.407.
6. Mokhtari T, Hassani F, Ghaffari N, Ebrahimi B, Yarahmadi A, Hassanzadeh G. COVID-19 and multiorgan failure: A narrative review on potential mechanisms. J Mol Histol. 2020 Dec;51(6):613-628. https://doi.org/10.1007/s10735-020-09915-3.
7. Mancuso P, Gidaro A, Gregato G, Raveane A, Cremonesi P, Quarna J, Caccia S, Gusso L, Rusconi S, Giacomelli A, Cogliati C, Bertolini F. Circulating endothelial progenitors are increased in COVID-19 patients and correlate with SARS-CoV-2 RNA in severe cases. J Thromb Haemost. 2020 Oct;18(10):2744-2750. https://doi.org/10.1111/jth.15044.
8. Mancia G, Rea F, Ludergnani M, Apolone G, Corrao G. Renin-Angiotensin-Aldosterone System Blockers and the Risk of Covid-19. N Engl J Med. 2020 Jun 18;382(25):2431-2440. https://doi.org/10.1056/NEJMoa2006923.
9. Mancia G, Kreutz R, Brunström M, Burnier M, Grassi G, Januszewicz A, Muiesan ML, Tsioufis K, Agabiti-Rosei E, Algharably EAE, Azizi M, Benetos A, Borghi C, Hitij JB, Cifkova R, Coca A, Cornelissen V, Cruickshank JK, Cunha PG, Danser AHJ, Pinho RM, Delles C, Dominiczak AF, Dorobantu M, Doumas M, Fernández-Alfonso MS, Halimi JM, Járai Z, Jelaković B, Jordan J, Kuznetsova T, Laurent S, Lovic D, Lurbe E, Mahfoud F, Manolis A, Miglinas M, Narkiewicz K, Niiranen T, Palatini P, Parati G, Pathak A, Persu A, Polonia J, Redon J, Sarafidis P, Schmieder R, Spronck B, Stabouli S, Stergiou G, Taddei S, Thomopoulos C, Tomaszewski M, Van de Borne P, Wanner C, Weber T, Williams B, Zhang ZY, Kjeldsen SE. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). J Hypertens. 2023 Dec 1;41(12):1874-2071. doi: 10.1097/HJH.0000000000003480. Epub 2023 Sep 26. Erratum in: J Hypertens. 2024 Jan 1;42(1):194. https://doi.org/10.1097/HJH.0000000000003621.
10. Puntmann VO, Martin S, Shchendrygina A, Hoffmann J, Ka MM, Giokoglu E, Vanchin B, Holm N, Karyou A, Laux GS, Arendt C, De Leuw P, Zacharowski K, Khodamoradi Y, Vehreschild MJGT, Rohde G, Zeiher AM, Vogl TJ, Schwenke C, Nagel E. Long-term cardiac pathology in individuals with mild initial COVID-19 illness. Nat Med. 2022 Oct;28(10):2117-2123. https://doi.org/10.1038/s41591-022-02000-0.
11. Chlabicz M, Dubatowka M, Jamiolkowski J et al. Enlarged dimensions of cardiac chambers and the root of the aorta as a significant cardiovascular impact of pandemic COVID-19: a population-based study. Eur J Prev Cardiol. 2023, 30(Supplement_1). https://d-nb.info/1369271336/34.
12. Podrug M, Koren P, Dražić Maras E, Podrug J, Čulić V, Perissiou M, Bruno RM, Mudnić I, Boban M, Jerončić A. Long-Term Adverse Effects of Mild COVID-19 Disease on Arterial Stiffness, and Systemic and Central Hemodynamics: A Pre-Post Study. J Clin Med. 2023 Mar 8;12(6):2123. https://doi.org/10.3390/jcm12062123.
13. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, Clement DL, Coca A, de Simone G, Dominiczak A, Kahan T, Mahfoud F, Redon J, Ruilope L, Zanchetti A, Kerins M, Kjeldsen SE, Kreutz R, Laurent S, Lip GYH, McManus R, Narkiewicz K, Ruschitzka F, Schmieder RE, Shlyakhto E, Tsioufis C, Aboyans V, Desormais I; ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018 Sep 1;39(33):3021-3104. doi: 10.1093/eurheartj/ehy339. Erratum in: Eur Heart J. 2019 Feb 1;40(5):475. https://doi.org/10.1093/eurheartj/ehy686.
14. Angeli F, Zappa M, Verdecchia P. Global burden of new-onset hypertension associated with severe acute respiratory syndrome coronavirus 2 infection. Eur J Intern Med. 2024 Jan;119:31-33. https://doi.org/10.1016/j.ejim.2023.10.016.
15. Marozzi MS, Fucile I, Panettieri I, Pagani M, Curcio R, Corvasce F, Falcone GS, Mancusi C, Izzo R, Vacca A, Cicco S. COVID-19 induces greater difficulty in blood pressure control due to increased arterial stiffness. Intern Emerg Med. 2025 Nov;20(8):2421-2432. https://doi.org/10.1007/s11739-025-04138-4.
16. Poryadok «Protokol nadannya medychnoyi dopomohy dlya likuvannya koronavirusnoyi khvoroby (COVID-19)» https://www.dec.gov.ua/wp-content/uploads/2022/02/2020_762_nakaz_covid19.pdf.
17. Babak V, Biletskiy A, Pristavka O, Pristavka P. Statistychna obrobka danix. 2001; 387.
18. Вознюк О. Особливості ремоделювання серця та судин у пацієнтів, які перенесли коронавірусну хворобу. USMYJ [Інтернет]. 22 грудня 2025 р. [цитовано 19 березня 2026 р.];158(4):51-4. Доступно за посиланням: https://mmj.nmuofficial.com/index.php/journal/article/view/599
19. Xie Y, Xu E, Bowe B, Al-Aly Z. Long-term cardiovascular outcomes of COVID-19. Nat Med. 2022 Mar;28(3):583-590. doi: 10.1038/s41591-022-01689-3.
20. Huseynov A, Akin I, Duerschmied D, Scharf RE. Cardiac Arrhythmias in Post-COVID Syndrome: Prevalence, Pathology, Diagnosis, and Treatment. Viruses. 2023 Jan 29;15(2):389. https://doi.org/10.3390/v15020389.
21. Bielecka E, Sielatycki P, Pietraszko P, Zapora-Kurel A, Zbroch E. Elevated Arterial Blood Pressure as a Delayed Complication Following COVID-19-A Narrative Review. Int J Mol Sci. 2024 Feb 2;25(3):1837. https://doi.org/10.3390/ijms25031837.
22. Marques KC, Silva CC, Trindade SDS, Santos MCS, Rocha RSB, Vasconcelos PFDC, Quaresma JAS, Falcão LFM. Reduction of Cardiac Autonomic Modulation and Increased Sympathetic Activity by Heart Rate Variability in Patients With Long COVID. Front Cardiovasc Med. 2022 Apr 29;9:862001. https://doi.org/10.3389/fcvm.2022.862001.
23. Dani M, Dirksen A, Taraborrelli P, Torocastro M, Panagopoulos D, Sutton R, Lim PB. Autonomic dysfunction in 'long COVID': rationale, physiology and management strategies. Clin Med (Lond). 2021 Jan;21(1):e63-e67. https://doi.org/10.7861/clinmed.2020-089.
24. Hultström M, von Seth M, Frithiof R. Hyperreninemia and low total body water may contribute to acute kidney injury in COVID-19 patients in intensive care. J Hypertens. 2020 Aug;38(8):1613-1614. https://doi.org/10.1097/HJH.0000000000002531.
25. Saeed S, Tadic M, Larsen TH, Grassi G, Mancia G. Coronavirus disease 2019 and cardiovascular complications: focused clinical review. J Hypertens. 2021 Jul 1;39(7):1282-1292. https://doi.org/10.1097/HJH.0000000000002819.
26. Brown JT, Saigal A, Karia N, Patel RK, Razvi Y, Constantinou N, Steeden JA, Mandal S, Kotecha T, Fontana M, Goldring J, Muthurangu V, Knight DS. Ongoing Exercise Intolerance Following COVID-19: A Magnetic Resonance-Augmented Cardiopulmonary Exercise Test Study. J Am Heart Assoc. 2022 May 3;11(9):e024207. https://doi.org/10.1161/JAHA.121.024207.
27. Rohun J, Dorniak K, Faran A, Kochańska A, Zacharek D, Daniłowicz-Szymanowicz L. Long COVID-19 Myocarditis and Various Heart Failure Presentations: A Case Series. J Cardiovasc Dev Dis. 2022 Nov 30;9(12):427. https://doi.org/10.3390/jcdd9120427.
28. Kapusta J, Babicki M, Pieniawska-Śmiech K, Kałuzińska-Kołat Ż, Kołat D, Jankowski P, Kasprzak JD, Wejner-Mik P, Bianek-Bodzak A, Chudzik M. Clinical and electrocardiographic correlates of myocardial dysfunction after COVID-19 in nonhospitalised patients in long-term follow-up. Data from the polish long-covid cardiovascular study. J Med Virol. 2023 Dec;95(12):e29331. https://doi.org/10.1002/jmv.29331.
29. Ingul CB, Grimsmo J, Mecinaj A, Trebinjac D, Berger Nossen M, Andrup S, Grenne B, Dalen H, Einvik G, Stavem K, Follestad T, Josefsen T, Omland T, Jensen T. Cardiac Dysfunction and Arrhythmias 3 Months After Hospitalization for COVID-19. J Am Heart Assoc. 2022 Feb;11(3):e023473. https://doi.org/10.1161/JAHA.121.023473.
30. Wang W, Wang CY, Wang SI, Wei JC. Long-term cardiovascular outcomes in COVID-19 survivors among non-vaccinated population: A retrospective cohort study from the TriNetX US collaborative networks. EClinicalMedicine. 2022 Nov;53:101619. doi: 10.1016/j.eclinm.2022.101619. Epub 2022 Aug 11. Erratum in: EClinicalMedicine. 2023 May;59:101968. https://doi.org/10.1016/j.eclinm.2023.101968.
ISSN 
ISSN 
