ABSTRACT
BACKGROUND: Hypertension is a significant risk factor for cardiovascular disease, a leading cause of death among people living with HIV (PLWH). Studies suggest that hypertension prevalence among PLWH is high, yet none assess how the 2017 redefinition of hypertension as ≥130/80 rather than the previous standard of ≥140/90 mm Hg will affect prevalence among PLWH. This study addresses this gap. METHODS: We examined medical record abstractions of 957 PLWH in Texas from the 2013-2014 Medical Monitoring Project survey. Participants with hypertension were identified by charted diagnosis, antihypertensive medication use, or blood pressure readings ≥140/90 and ≥130/80 mm Hg. Associations with sociodemographic and clinical variables were assessed using Rao-Scott chi-square tests, and odds of having hypertension were calculated using multivariable logistic regression models while adjusting for several demographic and HIV-related variables. RESULTS: The 2017 redefinition of hypertension increased prevalence in the sample by 44.3%, from 47.6% to 68.7%. Age group, body mass index, sex, and race remained significantly associated with hypertension (all P < 0.01). Although prevalence was near equal between males and females at ≥140/90 mm Hg (47.4% and 48.5%, respectively), males were 2.36 times more likely to have hypertension than females (95% confidence interval [CI]: 1.55-3.60) at ≥130/80 mm Hg. Prevalence remained comparable between white (73.3%) and black participants (72.9%). CONCLUSIONS: This study shows that hypertension prevalence is remarkably high among PLWH and is further increased by updated guidelines. Barriers to hypertension control in the HIV care setting should be identified and addressed to facilitate continued improvement in the quality and length of life for PLWH.
Subject(s)
Blood Pressure Determination/standards , Blood Pressure , HIV Infections/epidemiology , HIV Long-Term Survivors , Hypertension/diagnosis , Hypertension/epidemiology , Practice Guidelines as Topic , Adolescent , Adult , Age Distribution , Anti-HIV Agents/therapeutic use , Antihypertensive Agents/therapeutic use , Blood Pressure/drug effects , Comorbidity , Cross-Sectional Studies , Databases, Factual , Female , HIV Infections/diagnosis , HIV Infections/drug therapy , Humans , Hypertension/drug therapy , Hypertension/physiopathology , Male , Middle Aged , Predictive Value of Tests , Prevalence , Race Factors , Risk Assessment , Risk Factors , Sex Distribution , Texas/epidemiology , Young AdultABSTRACT
Using representative data among 1861 in care people living with HIV (PLWH) in four southern states (Texas, Mississippi, Florida, and Georgia) from the 2013-2014 Medical Monitoring Project (MMP) survey, we estimated the prevalence and odds of metabolic syndrome (MetS) among various demographic and HIV related risk factors. Overall MetS prevalence was 34%, with our participants being mostly black (55%), male (72%), ≥ 50 years old (46%), and overweight or obese (60%) with undetectable viral loads (≤ 200 copies/ml, 69%), and were currently taking antiretroviral medication (98%). Compared to those who were ≥ 60 years, 18-39 year olds had a 79% (95% CI 0.13-0.33) lower odds of having MetS. Women were 2.24 times more likely to have MetS than men (95% CI 1.69-2.97). Age and sex were significant predictors of MetS. Since MetS is a combination of chronic disease risk factors, regular screening for MetS risk factors among aging PLWH is crucial.