Format

Send to

Choose Destination
Clin Infect Dis. 2016 Jul 15;63(2):242-8. doi: 10.1093/cid/ciw223. Epub 2016 Apr 18.

Hypertension Among HIV-infected Patients in Clinical Care, 1996-2013.

Author information

1
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill Division of Infectious Diseases, Department of Medicine, Duke University, Durham.
2
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill.

Abstract

BACKGROUND:

Persons infected with human immunodeficiency virus (HIV) are at higher risk for major cardiovascular disease (CVD) events than uninfected persons. Understanding the epidemiology of major traditional CVD risk determinants, particularly hypertension, in this population is needed.

METHODS:

The study population included HIV-infected patients participating in the UNC CFAR HIV Clinical Cohort from 1996 to 2013. Annual incidence rates of hypertension were calculated. Multivariable Poisson models were fit to identify factors associated with incident hypertension.

RESULTS:

3141 patients contributed 21 956 person-years (PY) of follow-up. Overall, 57% patients were black, 28% were women, and the median age was 35 years. Hypertension age-standardized incidence rates increased from 1.68 cases per 100 PYs in 1996 to 5.35 cases per 100 PYs in 2013 (P < .001). In adjusted analyses, hypertension rates were higher among obese patients (incidence rate ratio [IRR] 1.70, 95% confidence interval [CI], 1.43-2.02), and those with diabetes mellitus (IRR 1.44, 95% CI, 1.14-1.83) and renal insufficiency (IRR 1.36, 95% CI, 1.16-1.61), but lower among patients with a CD4 nadir of ≥500 cells/mm(3) (IRR 0.73, 95% CI, .53-1.01).

CONCLUSIONS:

The incidence of hypertension increased from 1996 to 2013, alongside increases in traditional hypertension risk determinants. Notably, HIV-related immunosuppression and ongoing viral replication may contribute to an increased hypertension risk. Aggressive CVD risk factor management, early HIV diagnosis, linkage to care, antiretroviral therapy initiation, and durable viral suppression, will be important components of a comprehensive primary CVD prevention strategy in HIV-infected persons.

KEYWORDS:

HIV; UCHCC; cardiovascular disease; epidemiology; hypertension

PMID:
27090989
PMCID:
PMC6276923
DOI:
10.1093/cid/ciw223
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Silverchair Information Systems Icon for PubMed Central
Loading ...
Support Center