Incidence of hypertension among persons living with HIV in China: a multicenter cohort study

Fan, Hongwei; Guo, Fengjin; Hsieh, Evelyn; Chen, Wei-Ti; Lv, Wei; Han, Yang; Xie, Jing; Li, Yanling; Song, Xiaojing; Li, Taisheng

doi:10.1186/s12889-020-08586-9

Cited by 13 publications

(16 citation statements)

References 44 publications

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“…Our findings indicate that the incidence of hypertension was 11.7%, which is lower than what has previously been reported in high-income countries (23)(24)(25) and other studies from Sub-Saharan Africa (26-28). The reason for the difference is not clear but could be related to other factors including diet and ethnicity as well as specific ART regimens.…”

Section: Discussioncontrasting

confidence: 81%

Sex differences in hypertension among people living with HIV after initiation of antiretroviral therapy

Masenga

Povia²,

Mutengo³

et al. 2022

Front. Cardiovasc. Med.

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BackgroundHypertension is common in people living with HIV (PLWH) on antiretroviral therapy (ART). In the general population and in experimental animal models, the incidence of hypertension is greater in males than in females, especially during the premenopausal period. However, it is not known whether there are sex differences in hypertension associated with HIV and ART, and the factors contributing to incident hypertension among PLWH have not been well characterized. In this study, we aimed to determine the time course, sex differences and factors associated with incident hypertension in PLWH initiating ART.Methods and resultsWe conducted a retrospective study in which we used programmatic data from the ART registry to identify sex differences in the determinants of incident hypertension among PLWH initiating the ART regimen from Livingstone University Teaching Hospital in Zambia and followed for 8 years. Males developed hypertension earlier, 2 years after initiating ART, compared to 6 years in females. In multivariable analysis, increasing age, baseline systolic blood pressure and baseline mean arterial pressure (MAP) were associated with increased risk for developing incident hypertension. Also, participants who switched to the integrase strand transfer inhibitor, dolutegravir (DTG) or the protease inhibitor, lopinavir boosted with ritonavir were 2 and 3 times more likely to develop hypertension when compared to those on non-nucleoside reverse transcriptase inhibitors (NNRTIs). However, these relationships were abrogated by sex, as self-reported male sex was the major contributor in predicting incident hypertension. While none of the factors remained significantly associated with incident hypertension upon multivariate analysis among females, body mass index (BMI), and use of protease inhibitors remained strongly associated with hypertension among males.ConclusionOur results indicate that the use of protease inhibitors and BMI are important predictors of incident hypertension among males. Thus, blood pressure and BMI should be closely monitored, particularly in males living with HIV on protease inhibitors. In addition, identifying specific factors that protect females from developing hypertension early is important but remains to be determined.

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Section: Discussioncontrasting

confidence: 81%

Sex differences in hypertension among people living with HIV after initiation of antiretroviral therapy

Masenga

Povia²,

Mutengo³

et al. 2022

Front. Cardiovasc. Med.

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“…America 28 and China. 29 The higher incident in this study might be attributed to the lower cut off value (>130/ 80mmhg) to diagnose incident hypertension. Differences in sample size, study design (prospective Vs retrospective cohort), study setting, and socio-demographic characteristics of study participants might be the additional reasons for incidence rate variations.…”

Section: Discussionmentioning

confidence: 64%

“…36,37 However, a similar cohort study in China revealed that zidovudine exposure was a protective factor for hypertension among HIV patients. 29 Controlling high blood pressure is critical in HIV positive individuals to prevent organ damage and ultimately reduce mortality. 38,39 The burden of non-communicable diseases like hypertension in HIV positive patients can be minimized by implementing risk reduction interventions and strategies.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Predictors of Hypertension Among HIV Patients Receiving ART at Public Health Facilities, Northwest Ethiopia: A One-Year Multicenter Prospective Follow-Up Study

Mulugeta¹,

Afenigus²,

Haile³

et al. 2021

HIV

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Background: The introduction of highly active retroviral therapy has dramatically reduced mortality and improved survival among HIV patients. However, there is a possible risk of comorbid complications such as hypertension. Little evidence is available regarding the incidence of hypertension among HIV patients receiving anti-retroviral therapy in Ethiopia. Purpose: To assess the incidence and predictors of hypertension among HIV positive patients receiving ART at Public Health Facilities, Northwest Ethiopia. Patients and Methods: A one-year prospective follow-up study was conducted among a cohort of 302 new adult individuals initiating on a standard anti-retroviral therapy regimen with a median (IQR) age of 35 years (IQR=30-41). A pretested data extraction checklist was used to extract baseline patient records. The collected data were entered into Epi-Data version 3.1 and exported to STATA version 14 for analysis. The incidence rate was calculated, and a Kaplan-Meier survival curve was used to estimate the survival probabilities of developing hypertension. Cox proportional hazards model was fitted to identify the predictors of hypertension. Results: About 40 (13.25) new hypertensive cases were observed during the follow-up period, and the remaining 262 (86.75%) were censored. The overall incidence rate of hypertension was 16.35 per 1000 person-month with 2447 patient-month observations. Male sex (AHR = 2.45, 95% CI: 1.02, 6.14), old age (AHR = 2.83, 95% CI: 1.08, 7.45), high BMI (AHR = 6.54, 95% CI: 2.03, 21.13), diabetic comorbidity (AHR = 2.36, 95% CI: 1.07, 5.22), and patients who were on Zidovudine (AZT)-based ART regimen (AHR =3.47, 95% CI: 1.10, 10.94) were significant predictors for the development of hypertension. Conclusion:The findings of this study revealed that incident hypertension is a common problem among HIV patients receiving ART. Routine monitoring of blood pressure and screening and treating high blood pressure should be an integral part of follow-up for HIV patients in ART clinics.

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“…[42] A large number of studies have been published during the past 5 years worldwide on the effect of aging with HIV on non-AIDS associated comorbidities. [43][44][45][46][47] Data from the United States (US) showed that the prevalence of multimorbidities (≥2) among a cohort of more than 22,900 of PLHIV increased from 8% to 22% during a 9-year period of follow-up. [48] Hypertension and hypercholesterolemia were the most common co-occurred comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Trends & predictors of non-AIDS comorbidities among people living with HIV and receiving antiretroviral therapy in Lebanon

et al. 2022

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Combined antiretroviral therapy (cART) increased the life expectancy of people living with Human Immunodeficiency Virus (HIV) (PLHIV) and remarkably reduced the morbidity and mortality associated with HIV infection. Consequently, PLHIV are experiencing non-acquired immunodeficiency syndrome (AIDS) associated comorbid conditions including diabetes, hyperlipidemia, hypertension, and cardiovascular disease. The aim of this study is to determine the frequency of non-AIDS associated comorbid conditions among a cohort of PLHIV on cART in Lebanon. Data were collected between November 2018 and December 2019 from 105 voluntary participants. A standardized questionnaire was used to collect demographic and behavioral data including lifestyle, smoking, physical activity, substance use and abuse in addition to co-infections and family history of non-communicable diseases. Moreover, data on occurrence and treatment of cardiovascular disease, hypertension, diabetes, lipid and metabolic disorders as well as mental health were collected. Blood samples were used to assess the levels of fasting blood sugar (FBS), glycosylated hemoglobin (HbA1C), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein, total cholesterol, and serum creatinine. Hypertension (29.5%) and hyperlipidemia (29.5%) followed by diabetes (23.7%) and cardiovascular disease (9.7%) were mainly reported among study participants. Higher rate of comorbid conditions was observed among participants >40 years of age than those ≤40 years with both hypertension and hyperlipidemia most commonly reported. Older age (odds ratio [OR] 7.6; 95% CI: 1.83-31.98; P = .005) is associated with higher odds of having hyperlipidemia. Moreover, participants on cART for ≥10 years are 5 times more likely to have hyperlipidemia (OR 5; 95% CI: 1.08-22.73; P = .039). Our results also showed that study participants did not experience anxiety, depression or somatic symptoms and that there was no association between these mental disorders and older age or comorbidities. Our results provide important information on HIV trends and associated comorbidities in Lebanon and can be used to improve the management of non-communicable diseases among PLHIV.

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Incidence of hypertension among persons living with HIV in China: a multicenter cohort study

Cited by 13 publications

References 44 publications

Sex differences in hypertension among people living with HIV after initiation of antiretroviral therapy

Sex differences in hypertension among people living with HIV after initiation of antiretroviral therapy

Incidence and Predictors of Hypertension Among HIV Patients Receiving ART at Public Health Facilities, Northwest Ethiopia: A One-Year Multicenter Prospective Follow-Up Study

Trends & predictors of non-AIDS comorbidities among people living with HIV and receiving antiretroviral therapy in Lebanon

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