Association between exposure to antiretroviral drugs and the incidence of hypertension in <scp>HIV</scp>‐positive persons: the Data Collection on Adverse Events of Anti‐<scp>HIV</scp> Drugs (D:A:D) study

Hatleberg, Camilla Ingrid; Ryom, Lene; Monforte, Antonella d’Arminio; Fontas, Éric; Reiss, Peter; Kirk, Ole; El‐Sadr, Wafaa; Phillips, Andrew; Wit, Stéphane De; Dabis, François; Weber, Rainer; Law, Matthew; Lundgren, JD; Sabin, Caroline

doi:10.1111/hiv.12639

Cited by 38 publications

(56 citation statements)

References 41 publications

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“…Higher BMI was found to be associated with an increased risk of prevalent hypertension in our patients. is finding was in agreement with the study from the country [23] and other studies elsewhere [15,27,31,35], indicating that HIVinfected patients classified as overweight or obese were at an increased risk of developing hypertension. Our study also found a significant association between the presence of diabetes and prevalence of hypertension.…”

Section: Discussionsupporting

confidence: 93%

“…e increased risk of hypertension observed among older HIV-infected patients on ART in our study is consistent with previous studies [14,24,27,31,34]. ese and other related studies [15,35] showed that older patients had an increased risk of prevalent hypertension and should be targeted for frequent blood pressure monitoring and the identification of other risk factors to encourage lifestyle modification. We also observed a significant association between male gender and hypertension in our study population, and this was in agreement with previous reports [15,34,35], which indicated that male patients were at an increased risk of hypertension during their time on ART.…”

Section: Discussionsupporting

confidence: 92%

“…In this study, renal insufficiency was also significantly associated with an increased risk of hypertension only in univariate analyses but not in multivariate analyses. An independent association between renal insufficiency and hypertension in patients living with HIV on ART has previously been reported in other related studies [35,37].…”

Section: Discussionsupporting

confidence: 68%

“…is is also supported by a previous study conducted in the country [23], which showed that raised blood glucose was significantly associated with prevalent hypertension. Additionally, previous study has shown that diabetes was also an independent predictor of hypertension among HIV-infected adults in the ART era [35]. In this study, renal insufficiency was also significantly associated with an increased risk of hypertension only in univariate analyses but not in multivariate analyses.…”

Section: Discussionsupporting

confidence: 39%

“…ese and other related studies [15,35] showed that older patients had an increased risk of prevalent hypertension and should be targeted for frequent blood pressure monitoring and the identification of other risk factors to encourage lifestyle modification. We also observed a significant association between male gender and hypertension in our study population, and this was in agreement with previous reports [15,34,35], which indicated that male patients were at an increased risk of hypertension during their time on ART. However, no significant association between gender and hypertension was observed in a previous study conducted in the country [23].…”

Section: Discussionmentioning

confidence: 95%

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Hypertension in HIV-Infected Patients Receiving Antiretroviral Therapy in Northeast Ethiopia

Fiseha

Gedefie

Dereje

et al. 2019

International Journal of Hypertension

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Background. With prolonged survival and aging of persons with HIV on combination antiretroviral therapy (ART), hypertension has emerged as a significant cause of morbidity and mortality globally. However, little is known about the burden of this comorbid condition among adults living with HIV in sub-Saharan Africa. In this study, we aimed to determine the prevalence and factors associated with hypertension among HIV-infected patients receiving ART in Northeast Ethiopia. Methods. A cross-sectional study was conducted at the ART clinic of Dessie Referral Hospital, Northeast Ethiopia, between January and May 2018. HIV-infected patients who were on ART for at least 12 months were included in the study. Demographic, clinical, and laboratory data were collected from each participant. Hypertension was defined as a systolic blood pressure (BP) of ≥140 mmHg and/or diastolic BP of ≥90 mmHg or a reported use of antihypertensive medication. Univariable and multivariate analyses were performed to identify factors associated with hypertension. Results. A total of 408 patients were studied with a mean (±SD) age of 37 ± 10.3 years, and 66.9% were female. The prevalence of hypertension was 29.7% (95% CI, 25.3–35.0%). Nearly 75% of the patients with hypertension were previously undiagnosed. In a univariate analysis, older age, male gender, a family history of hypertension, duration of HIV infection, duration on ART, high body mass index, low CD4 count, diabetes, and renal impairment were associated with hypertension. Multivariate analysis revealed older age (AOR = 2.08; 95% CI, 1.13–3.83), male gender (AOR = 1.64; 95% CI, 1.01–2.65), longer duration on ART (AOR = 1.91; 95% CI, 1.14–3.20), high body mass index (AOR = 3.32; 95% CI, 1.13–9.77), and diabetes (AOR = 2.76; 95% CI, 1.29–5.89) as independent risk factors of hypertension. Conclusions. Hypertension is highly prevalent among HIV-infected patients on ART attending our clinic in Northeast Ethiopia but is mostly undiagnosed. These findings highlight the need for integrating hypertension management into routine HIV care to prevent adverse outcomes and improve health of people living with HIV on ART.

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