The COVID-19 pandemic has raised concerns about continuity of care for chronic diseases such as diabetes, hypertension, and dyslipidemia. Although studies have documented declines in healthcare utilization, few have assessed individual-level patterns of treatment interruption.

We conducted a retrospective cohort analysis using administrative claims data (2018-2021) from a Prefecture, Japan. Eligible patients were diagnosed with and prescribed medications for diabetes mellitus, hypertension, or dyslipidemia in January of 2019 or 2020 and followed until December of each year. The primary outcome was the time-to- interruption of physician visits, defined as a gap of at least 60 days between follow-up visits. We used Cox proportional hazards regression, adjusted for age, sex, comorbidities, and prior healthcare utilization, to compare the risk of treatment interruption in 2020 (COVID-19 group) vs. 2019 (pre-pandemic group). Sensitivity analyses were performed with thresholds of 30 and 90 days. Logistic regression examined whether pandemic-related interruptions were associated with the likelihood of returning to treatment within one year.

A total of 410,911 patients met the inclusion criteria. Across all three chronic conditions, the hazard of interruption was significantly higher in 2020 than in 2019; adjusted HRs are 1.26 (95% CI = 1.17-1.36) for diabetes, 1.39 (95%CI = 1.31-1.47) for hypertension, and 1.24 (95%CI = 1.17-1.32) for dyslipidemia, respectively. No significant difference in resuming care was observed between the 2020 and 2019 interruptions (OR = 0.89; 95% CI = 0.81-1.09). Sensitivity analyses showed consistent findings, despite slight variations in hazard ratios for different gap thresholds.

The COVID-19 pandemic was associated with an increased risk of treatment interruption in patients with chronic diseases, underscoring the need for targeted strategies to maintain care continuity during public health emergencies. While older patients and those with multimorbidity showed earlier interruptions, the overall patterns persisted across disease groups, emphasizing the importance of preemptive measures and patient outreach to prevent delayed or forgone care.

Arterial stiffness has been recognized as a marker of cardiovascular disease and associated with long-term worse clinical outcomes in several populations. Age, hypertension, smoking, and dyslipidemia, known as traditional vascular risk factors, as well as diabetes, obesity, and systemic inflammation lead to both atherosclerosis and arterial stiffness. Targeting multiple modifiable risk factors has become the main therapeutic strategy to improve arterial stiffness in patients at high cardiovascular risk. Additionally to life style modifications, long-term ω-3 fatty acids (fish oil) supplementation in diet may improve arterial stiffness in the population with hypertension or metabolic syndrome. Pharmacological treatment such as renin-angiotensin-aldosterone system antagonists, metformin, and 3-hydroxy-3-methyl-glutaryl-CoA reductase inhibitors were useful in individuals with hypertension and diabetes. In obese population with obstructive sleep apnea, weight reduction, aerobic exercise, and continuous positive airway pressure treatment may also improve arterial stiffness. In the populations with chronic inflammatory disease such as rheumatoid arthritis, a use of antibodies against tumor necrosis factor-alpha could work effectively. Other therapeutic options such as renal sympathetic nerve denervation for patients with resistant hypertension are investigated in many ongoing clinical trials. Therefore our comprehensive review provides knowledge in detail regarding many aspects of pathogenesis, measurement, and management of arterial stiffness in several populations, which would be helpful for physicians to make clinical decision.