Blood pressure and mortality in a prospective cohort of HIV-infected adults in Port-au-Prince, Haiti.
J Hypertens
; 36(7): 1533-1539, 2018 07.
Article
em En
| MEDLINE
| ID: mdl-29634661
ABSTRACT
OBJECTIVE:
The objective of this study was to determine how baseline blood pressure and incident hypertension related to antiretroviral therapy (ART) initiation, HIV-related inflammation and mortality in HIV-infected adults in a low-income country.METHODS:
We conducted long-term follow-up of HIV-infected adults who had participated in a trial of early vs. delayed initiation of ART in Port-au-Prince, Haiti. Between 2005 and 2008, 816 HIV-infected adults were randomized to early (Nâ=â408) vs. delayed ART (when CD4 cell count <200âcells/µl or AIDS-defining condition; Nâ=â408). Blood pressure was measured every 3 months. Hypertension was diagnosed according to the Joint National Committee (JNC-7) guidelines. Biomarkers of inflammation and coagulation were measured from banked enrolment plasma samples. Survival analyses were performed using Stata 14.RESULTS:
The median age at enrolment was 39 years. The median follow-up time was 7.3 years. The hypertension incidence rate was 3.41 per 100 person-years, and was similar in early and delayed ART groups. In multivariable models, independent predictors of incident hypertension were older age, higher BMI and plasma interleukin (IL)-6 levels (adjusted hazard ratio, aHRâ=â1.23, Pâ<â0.001). Systolic pressure more than 140âmmHg at enrolment was associated with increased mortality (aHRâ=â2.47, Pâ=â0.03) as was systolic pressure less than 90âmmHg (aHRâ=â2.25, Pâ=â0.04). Prevalent and incident hypertension were also significantly associated with mortality.CONCLUSION:
In a large prospective study of HIV-infected adults, we found a high incidence of hypertension associated with HIV-related inflammation. Baseline hypertension conferred a more than two-fold increased risk of death. Among HIV-infected adults in low-income countries, hypertension should be considered a serious threat to long-term survival.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Pressão Sanguínea
/
Infecções por HIV
/
Países em Desenvolvimento
/
Hipertensão
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article