REVIEW article
Front. Cardiovasc. Med.
Sec. Hypertension
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1609768
Infection to Hypertension: A Review of Post-COVID-19 New-Onset Hypertension Prevalence and Potential Underlying Mechanisms
Provisionally accepted
- 1Mayo Clinic, Rochester, United States
- 2Department of Cadiovascular Medicine, Mayo Clinic, Rochester, Michigan, United States
- 3Department of Medicine, Division of Cardiology, Loma Linda University Medical Center, Loma Linda, United States
- 4Department of Medicine, Division of Nephrology, Loma Linda University Medical Center, Loma Linda, United States
- 5Division of Cardiology, Arrowhead Regional Medical Center, California University of Science and Medicine, California, United States
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Post-COVID New-onset hypertension (PCNH) is an increasingly reported complication among COVID-19 survivors. PCNH can emerge up to 12 months post-infection, 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, de-conditioning, and mental health decline may also impact the likelihood of PCNH. Conventional reninangiotensin system antagonists may help improve pathway distortions, while novel antiinflammatory 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.
Keywords: post-COVID complications, New-onset hypertension, Angiotensin-converting Enzyme pathway, Inflammation, Endothelial dysfunction Font: (Default) Calibri, Complex Script Font: Calibri Formatted: Justified Formatted: Font: (Default) Calibri, Complex Script Font: Calibri Formatted: Font: (Default) Calibri, Not Italic
Received: 10 Apr 2025; Accepted: 22 Jul 2025.
Copyright: © 2025 Teymourzadeh, Abramov, Norouzi, Grewal and Heidari-Bateni. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Giv Heidari-Bateni, Division of Cardiology, Arrowhead Regional Medical Center, California University of Science and Medicine, California, United States
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