D-Dimer Levels and Traditional Risk Factors Are Associated With Incident Hypertension Among HIV-Infected Individuals Initiating Antiretroviral Therapy in Uganda.
J Acquir Immune Defic Syndr
; 73(4): 396-402, 2016 Dec 01.
Article
em En
| MEDLINE
| ID: mdl-27171743
ABSTRACT
OBJECTIVES:
We sought to describe blood pressure (BP) changes after antiretroviral therapy (ART) initiation and evaluate the association of markers of inflammation with incident hypertension in a cohort of HIV-infected individuals in Uganda.METHODS:
We used mixed effects linear regression to model changes in systolic BP over time among a cohort of HIV-infected individuals initiating ART in Uganda. After exclusion of participants with preexisting hypertension, we identified participants with normal BP throughout follow-up (controls) and those with elevated BP on ≥3 consecutive visits (cases). Before ART initiation, participants had testing for interleukin 6, kynurenine/tryptophan ratio, lipopolysaccharide, soluble CD14, soluble CD163, and D-dimer and those with viral suppression at 6 months during ART had repeat tests. We fit logistic regression models to estimate associations between biomarkers and risk of incident hypertension.RESULTS:
In the entire cohort, systolic BP increased by 9.6 mm Hg/yr (95% CI 7.3 to 11.8) in the first 6 months of ART, then plateaued. Traditional factors male gender (adjusted odds ratio (AOR) 2.76, 95% CI 1.34 to 5.68), age (AOR 1.09, 95% CI 1.04 to 1.13), overweight (AOR 4.48, 95% CI 1.83 to 10.97), and a CD4 count <100 cells (AOR 3.08, 95% CI 1.07 to 8.89) were associated with incident hypertension. After adjusting for these, D-dimer levels at month 6 were inversely associated with incident hypertension (AOR 0.61, 95% CI 0.37 to 0.99). Although not significant, similar associations were seen with sCD14 and kynurenine/tryptophan ratio.CONCLUSION:
BP increases early after ART initiation in Ugandans. Traditional risk factors, rather than immune activation, were associated with incident hypertension in this population.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Produtos de Degradação da Fibrina e do Fibrinogênio
/
Infecções por HIV
/
Fármacos Anti-HIV
/
Hipertensão
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Female
/
Humans
/
Male
Idioma:
En
Revista:
J Acquir Immune Defic Syndr
Assunto da revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Ano de publicação:
2016
Tipo de documento:
Article