Background The coronavirus disease 2019 (COVID-19) pandemic has disrupted healthcare services, including chronic disease management, for vulnerable groups, such as older individuals with hypertension. This study aimed to evaluate hypertension management in South Korea’s elderly population during the pandemic using treatment consistency indices such as the continuity of care (COC), modified, modified continuity index (MMCI), and most frequent provider continuity (MFPC).
Methods This study used the Korea Disease Control and Prevention Agency-COVID-19-National Health Insurance Service cohort (K-COV-N cohort) from the National Health Insurance Service between 2017 and 2021. The research included a total of 4,097,299 hypertensive patients aged 65 years or older. We defined 2018 and 2019 as the baseline period before the COVID-19 pandemic and 2020 and 2021 as the COVID-19 period and calculated the indices of medical continuity (number of visits, COC, MMCI, and MFPC) on a yearly basis.
Results The number of visits decreased during the COVID-19 period compared to the baseline period (59.64±52.75 vs. 50.49±50.33, P<0.001). However, COC, MMCI, and MFPC were not decreased in the baseline period compared to the COVID-19 period (0.71±0.21 vs. 0.71±0.22, P<0.001; 0.97±0.05 vs. 0.96±0.05, P<0.001; 0.8±0.17 vs. 0.8±0.17, P<0.001, respectively).
Conclusion COVID-19 had no significant impact on the continuity of care but affected the frequency of outpatient visits for older patients with hypertension. However, this study highlights the importance of addressing healthcare inequalities, especially in older patients with hypertension, during pandemics and advocates for policy changes to ensure continued care for vulnerable populations.
Citations
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Trends of new diagnosis and treatment initiation of hypertension during the COVID-19 pandemic in Korea Jaeyong Lee, Ari Lee, Moses Song, Jiyen Han, Kyoung Hwa Ha, Hyeok-Hee Lee, Seng Chan You, Hyeon Chang Kim, Hokyou Lee Hypertension Research.2026; 49(5): 1639. CrossRef
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The impact of the COVID-19 Pandemic on hypertension phenotypes (ESH ABPM COVID-19 study) Aleksandra Ostrowska, Wiktoria Wojciechowska, Marek Rajzer, Thomas Weber, Michael Bursztyn, Alexandre Persu, George Stergiou, Grzegorz Kiełbasa, Marzena Chrostowska, Michaelis Doumas, Gianfranco Parati, Grzegorz Bilo, Guido Grassi, Giuseppe Mancia, Andrze European Journal of Internal Medicine.2024;[Epub] CrossRef
Background Sleep duration is associated with various health conditions, including chronic kidney disease. However, the association between sleep duration and decline in kidney function in the South Korean population remains unclear. We aimed to investigate the impact of sleep duration on kidney function decline in adult patients with hypertension.
Methods This cohort study was performed using data obtained from the Korean Genome and Epidemiology Study; 2,837 patients with hypertension who initially had normal kidney function were included. Glomerular filtration rates (GFRs) were estimated at baseline and throughout the 16 years of follow-up. A person was considered to have a decline in kidney function if they had a GFR <60 mL/min/1.73 m2. Sleep duration data were obtained through interviewer-assisted questionnaires. Sleep durations were classified as short (<6 hours), normal (≥6 hours but <9 hours), and long (≥9 hours). The Cox proportional hazards model was applied, with adjustments for covariates.
Results After adjusting for covariates, sleep duration was not associated with a decline in kidney function. However, among men with poorly controlled hypertension at baseline, compared to men with normal sleep durations, men with sleep durations <6 hours had a significantly higher risk of kidney function decline (hazard ratio, 1.56; 95% confidence interval, 1.02–2.36).
Conclusion Short sleep duration did not seem to be associated with an increased risk of decline in kidney function; however, it may be a risk factor for the decline in kidney function in men with poorly controlled hypertension.
Citations
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Sleep Duration and Chronic Kidney Disease Among Older US Adults Shirmila Syamala, Unnikrishnan Pillai, Nasseer A. Masoodi American Journal of Lifestyle Medicine.2026;[Epub] CrossRef
The risk of chronic kidney disease or proteinuria with long or short sleep duration: a systematic review and meta-analysis of cohort studies Meng Hu, Yongchong Wang, Wen Zhu, Xiaozhen Chen Clinical and Experimental Nephrology.2025; 29(3): 301. CrossRef
RETRACTED ARTICLE: Short or long sleep duration was associated with chronic kidney disease in the general population Gang Wang, Ning Zhuo, Zhichun Liu International Urology and Nephrology.2024; 56(7): 2441. CrossRef
The association of sleep duration with the risk of chronic kidney disease: a systematic review and meta-analysis Jin Hean Koh, Brian Sheng Yep Yeo, Timothy Wei En Tan, Mark Yong Siang See, Adele Chin Wei Ng, Shaun Ray Han Loh, Joshua Gooley, Chieh Suai Tan, Song Tar Toh Clinical Kidney Journal.2024;[Epub] CrossRef
Association of plant and animal protein intake with sleep quality and quality of life in hemodialysis patients: a multicenter cross-sectional study Saber Jafari Maskouni, Hossein Bavi Behbahani, Meysam Alipour, Ahmad Zare Javid, Fatemeh Fayazfar, Pardis Tofighzadeh, Shiva Shokri, Sara Keramatzadeh, Haleh Soltaniyan Dehkordi, Morteza Sharifat, Siavash Babajafari Esfandabad, Shokouh Shayanpour Frontiers in Nutrition.2024;[Epub] CrossRef
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