Hypertension, dyslipidaemia, and cardiovascular risk in HIV-infected adults in Poland

Rogalska, Magdalena; Rogalski, Paweł; Leszczyszyn-Pynka, Magdalena; Stempkowska, Justyna; Kocbach, Piotr; Kowalczuk-Kot, Aldona; Janczarek, Małgorzata; Grzeszczuk, Anna

doi:10.5603/kp.a2017.0148

Cited by 14 publications

(13 citation statements)

References 23 publications

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“…In our study, the median BMI was high, indicating that participants had excess body weight. Being overweight is a modifiable risk factor that was found to be associated with hypertension in the current study, which corroborates with the findings of a study conducted in Poland and another in Nigeria 17,18 . Smoking, another modifiable CVD risk factor, was found to be significantly associated with the hypertensive status in our study population.…”

Section: Discussionsupporting

confidence: 93%

Increased prevalence of hypertension among people living with HIV: where to begin?

Costa

Val²,

Macedo

et al. 2020

Rev. Soc. Bras. Med. Trop.

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Introduction: Cardiovascular diseases (CDVs) have become increasingly important for progressively older people living with HIV (PLHIV). Identification of gaps requiring improvement in the care cascade for hypertension, a primary risk factor for CVDs, is of utmost importance. This study analyzed the prevalence of hypertensive status and described the care cascade for hypertension screening, diagnosis, treatment, treatment adherence, and management in PLHIV. Methods: This cross-sectional study included 298 PLHIV (age >40 years) who visited a referral center in the western Brazilian Amazon. Data were collected through a structured questionnaire interview and medical examinations. Thus, information regarding sociodemographic and clinical aspects, blood pressure, weight, height, body mass index, and laboratory profile was obtained. Descriptive and analytical statistics were performed, and results were considered significant if p <0.05. Results: In total, 132 (44.3%) participants reported that their blood pressure was never measured. The prevalence of hypertension was found to be 35.9% (107/298). Of these 107 participants, only 36 (33.6%) had prior knowledge of their hypertensive status, and 19 of 36 (52.7%) participants had visited a physician or cardiologist to seek treatment. Adherence to the BP-lowering treatment was noted in 11 (10.2%) participants. Conclusions: An increased prevalence of hypertension was found, and most of the hypertensive participants were unaware of their hypertensive status. In addition, blood pressure control was poor in the study population. This indicated that public health professionals did not sufficiently consider the full spectrum of healthcare and disease management for PLHIV.

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Section: Discussionsupporting

confidence: 93%

Increased prevalence of hypertension among people living with HIV: where to begin?

Costa

Val²,

Macedo

et al. 2020

Rev. Soc. Bras. Med. Trop.

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“…However, HCV is known to disturb the glucose metabolism by direct and indirect influence on intracellular insulin signalling, which leads to insulin resistance, impaired glucose tolerance, or even type 2 diabetes mellitus [23]. Similarly to Cheng et al [24], we also did not observe any difference in MS incidence between populations with and without HCV coinfection, despite the known direct cytopathic influence of HCV on lipid profile resulting in reduction of cholesterol and/or TG levels [25]. These perturbations seem to resolve after successful viral clearance.…”

Section: Discussionsupporting

confidence: 54%

Metabolic syndrome in HIV infected adults in Poland

et al. 2018

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A b s t r a c tBackground: Metabolic syndrome (MS) is usually diagnosed based on the presence of abdominal obesity, elevated blood pressure (BP), elevated fasting plasma glucose, high serum triglycerides (TG), and low high-density lipoprotein (HDL) cholesterol levels. Whether HIV is associated with a higher prevalence of MS than in the general population remains unclear. Aim:The aim of the study was to determine the incidence of MS in the population of HIV-infected adults and its association with clinical, virological, and biochemical features. Methods:Two hundred and seventy HIV-infected Caucasian adult patients were enrolled in the study and evaluated based on clinical records in the years 2013-2015.Results: Metabolic syndrome was diagnosed in 60 of 270 (22%) patients, 47 (24%) males and 13 (17%) females, mostly (72%) aged above 40 years. The percentage of patients with diagnosed MS in specific age groups in comparison to the general Polish population for females aged < 40 years was 7% vs. 4%, and males in the same age -18% vs. 9%, for females aged 40-59 years -47% vs. 24.4%, and males -33% vs. 28.3%. Particular components of MS in the MS population were found as follows: body mass index > 30 kg/m 2 in 29%, waist circumference exceeding 94 cm in men and 80 cm in woman -87.5%, TG ≥ 150 mg/dL -82%, HDL cholesterol < 40/50 mg/dL (males/females) -42%, systolic/diastolic BP ≥ 130 mmHg/≥ 85 mmHg -83%, and fasting glucose > 100 mg/dL -42%. In stepwise multivariate logistic regression analysis, age (odds ratio [OR] 1.052, 95% confidence interval [CI] 1.018-1.088, p = 0.003) and nadir CD4 < 350 cells/mm 3 (OR 3.576, 95% CI 1.035-12.355, p = 0.04) were associated with MS. Patients with MS compared with those without this disorder had low, intermediate, high, and very high cardiovascular risk in 10% vs. 23%, 73% vs. 70%, 7% vs. 5%, and 10% vs. 2%, respectively (p = 0.006). Conclusions:Prevalence of MS in the HIV-infected population is higher than in the general Polish population. Age and low nadir CD4 were found to be associated with MS.

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“…27 Again, a recent case-control study from hypertension are not immediately apparent to us. We consider this finding unexpected given that hypertriglyceridemia was significantly associated with hypertension in a Polish HIV cohort 40 and in the general population. 41 In the Polish HIV cohort, 40 the authors noted though that hypertriglyceridemia was highly associated with protease inhibitor (PI)-based cART, but in this study, >98% of cART-exposed PLWH were on non-nucleoside reverse transcriptase inhibitor (NNRTI)-based cART.…”

Section: Discussionmentioning

confidence: 83%

Characteristics of hypertension among people living with HIV in Ghana: Impact of new hypertension guideline

Nichols

Singh

Hardy

et al. 2019

J of Clinical Hypertension

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Data on the burden of hypertension among people living with HIV (PLWH) in Africa are limited, especially after new expert consensus hypertension guidelines were published in 2017. The authors sought to assess the prevalence and factors associated with hypertension among PLWH. This is a cross‐sectional study involving PLWH on combination antiretroviral therapy (cART) (n = 250) compared with sex‐matched cART‐naïve PLWH (n = 201) in Ghana. Hypertension was defined as blood pressure ≥ 140/90 mm Hg or use of antihypertensive drugs. The authors also assessed the prevalence and predictors associated with hypertension using the recent guideline recommended cutoff BP ≥ 130/80 mm Hg. Multivariate logistic regression models were fitted to identify factors associated with hypertension among PLWH. The mean age of PLWH on cART was 45.7 ± 8.6 years, and 42.9 ± 8.8 years among PLWH cART‐naive with 81% of study participants being women. The prevalence of hypertension among PLWH on cART and PLWH cART‐naïve was 36.9% and 23.4%, P = 0.002 at BP ≥ 140/90 mm Hg and 57.2% and 42.3%, respectively, P = 0.0009, at BP ≥ 130/80 mm Hg. Factors associated with hypertension at BP ≥ 140/90 mm Hg in the PLWH group with adjusted odds ratio (95% CI) were increasing age, 2.08 (1.60‐2.71) per 10 years, and body mass index, 1.53 (1.24‐1.88) per 5 kg/m2 rise. At BP ≥ 130/80 mm Hg, cART exposure, aOR of 1.77 (95% CI: 1.20‐2.63), family history of hypertension, aOR of 1.43 (1.12‐1.83), and hypertriglyceridemia, aOR of 0.54 (0.31‐0.93), were associated with hypertension. Among PLWH, cART exposure was associated with higher prevalence of hypertension per the new guideline definition, a finding which warrants further investigation and possible mitigation.

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Hypertension, dyslipidaemia, and cardiovascular risk in HIV-infected adults in Poland

Cited by 14 publications

References 23 publications

Increased prevalence of hypertension among people living with HIV: where to begin?

Increased prevalence of hypertension among people living with HIV: where to begin?

Metabolic syndrome in HIV infected adults in Poland

Characteristics of hypertension among people living with HIV in Ghana: Impact of new hypertension guideline

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