The Association Between Hypertension and the Risk of COVID‐19 Morbidity and Mortality in a Large Adult Population in Central Iran: A Prospective Cohort Study

ABSTRACT Background Extensive research has established hypertension as a clinically significant risk factor, contributing to both increased disease severity (morbidity) and higher fatality rates (mortality) in COVID‐19 patients. One of the common prevalent comorbidities worldwide, hypertension, had a unique challenge during the pandemic, aggravating the severity of infections and related complications. Aims This study aims to investigate the association between hypertension and clinical outcomes, including morbidity and mortality, in COVID‐19 patients. Methods This study utilized data from the Yazd Health Study (YaHS), a prospective cohort that began in 2014 and includes a representative sample of 9568 adults aged 20–70 years. During the baseline phase (2014–2015), data on demographics, blood pressure, anthropometric measurements, and biochemical variables were collected, with follow‐up assessments conducted during the second wave (2022–2024) and annual check‐ins. The association between hypertension (defined as systolic BP > 140 mmHg or diastolic BP > 90 mmHg) and COVID‐19 outcomes was analyzed using logistic regression in SPSS version 20.0. Results A total of 9568 participants were enrolled, and COVID‐19 outcomes were recorded from February 2019 to February 2021. Hypertension was identified as a significant risk factor for COVID‐19 mortality, with multivariable logistic regression showing a strong association (OR = 2.483, 95% CI = 1.158–5.326, p = 0.019). However, no statistically significant association was found between hypertension and COVID‐19 morbidity. Conclusions This study found that individuals with hypertension had a significantly higher risk of mortality from COVID‐19, underscoring the importance of managing hypertension during the pandemic.