Hypertension and antihypertensive treatment in HIV-infected individuals. A longitudinal cohort study

Manner, Ingjerd W.; Bækken, Morten; Oektedalen, Olav; Os, Ingrid

doi:10.3109/08037051.2012.680742

Cited by 29 publications

(22 citation statements)

References 163 publications

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“…In this prospective, longitudinal study on BP, 542 patients attending the outpatient clinic at the Department of Infectious Diseases at Oslo University Hospital, Ullevål, finished the baseline study and 434 HIV‐infected patients (80%) completed the follow‐up study, as detailed previously 36 . Of the 108 patients lost to follow‐up, more were normotensive compared with those who completed the study (80.6% vs 65.2%, P =.002).…”

Section: Methodsmentioning

confidence: 88%

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Low Nadir CD4 Cell Count Predicts Sustained Hypertension in HIV‐Infected Individuals

Manner

Trøseid

Oektedalen

et al. 2012

J of Clinical Hypertension

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Hypertension is associated with cardiovascular disease in the human immunodeficiency virus (HIV)-infected population. The authors aimed to test the hypothesis whether advanced immunosuppression with low nadir CD4 lymphocyte cell count is a predictor of sustained hypertension in HIV-infected individuals. In a longitudinal study of an HIV cohort of 434 patients (43AE11 years, 72% men, 71% Caucasians), standardized blood pressure was measured in duplicate during 3 clinical visits both at baseline and after 3.4AE0.8 years. The lowest CD4 cell count in the individual history was recorded as nadir CD4. Both nadir CD4 cell count <50 cells ⁄ lL and duration of antiretroviral therapy (ART) were associated with sustained hypertension, and the highest proportion of hypertensive patients was observed in those who had both nadir CD4 cell count <50 cells ⁄ lL and prolonged ART duration. Nadir CD4 cellcount <50 cells ⁄ lL was an independent predictor of hypertension (adjusted odds ratio [OR], 2.48; 95% confidence interval [CI], 1.27-4.83), as was ART duration (adjusted OR, 1.13; 95% CI, 1.03-1.24). The predictive power of ART duration was more pronounced in patients with nadir CD4 cell count <50 cells ⁄ lL. Delaying ART initiation until a state of advanced immunosuppression might add to and even fuel the cardiovascular risk associated with ART. J Clin Hypertens (Greenwich). 2013; 15:101-106 Ó2012 Wiley Periodicals, Inc.

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Section: Methodsmentioning

confidence: 88%

“…Sustained hypertension was characterized as persistent hypertension both at baseline and at follow‐up. Because considerable dynamics in the hypertension status has been found in this population, 36 sustained hypertension was chosen as the main focus in this study.…”

Section: Methodsmentioning

confidence: 99%

Low Nadir CD4 Cell Count Predicts Sustained Hypertension in HIV‐Infected Individuals

Manner

Trøseid

Oektedalen

et al. 2012

J of Clinical Hypertension

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“…The rates we detected in this cohort appear similar to or higher than that of prior estimates among HIV positive populations in resource-rich settings. [26-28] For example, we estimated an overall incidence of hypertension of 111.5 per 1000 py (95% CI 101.9 - 121.7), which is higher in magnitude than estimates described among PLWH in Norway (29.8 per 1000 py, 95% CI 20.3–42.2),[28] a multi-center study in the United States (64.1 per 1000 py, 95% CI 58.7 - 69.9)[26], and from the D:A:D study cohort which enrolls participants from sites in Europe, the United States, and Australia (72.1/1000py, 95%CI 68.2 – 76.0). Although we cannot make direct comparisons from study to study, our data offer preliminary evidence of higher rates in our patient population than those from resource rich settings.…”

Section: Discussionmentioning

confidence: 99%

“…For hypertension specifically, studies have found both an increased risk of hypertension for those with HIV [11, 12], and an association between hypertension with elements of the metabolic syndrome, including insulin resistance and lipodystrophy [13, 14]. Similar, to other cardiovascular diseases, the risk of hypertension among those with HIV has been associated with duration of HIV infection [15, 16], as well as traditional risk factors [17, 18], suggesting that HIV infection might have independent effects. The data on the associations between ART and hypertension is inconclusive, with some studies noting increased risk with ART exposure [19], while others not [17, 20].…”

Section: Introductionmentioning

confidence: 99%

Incidence and predictors of hypertension in adults with HIV-initiating antiretroviral therapy in south-western Uganda

Okello¹,

Kanyesigye

Muyindike

et al. 2015

Journal of Hypertension

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“…A recent meta-analysis, including 49 studies with 63,554 participants from America, Europe, Africa and Asia from 1996 to 2014, reported an estimated hypertension prevalence of 12.7% for ART-naïve and 34.7% for ART-experienced participants (3). Epidemiological studies from the United States and several European countries have demonstrated incidence of hypertension among outpatient primary care and HIV clinics for PLWH ranging from 2.6 to 7.2 per 100 person-years (PYs) (4)(5)(6)(7)(8)(9). Studies from East Africa have reported incidence rates of 11.2-12.0 per 100 PYs (10,11).…”

Section: Introductionmentioning

confidence: 99%

Incidence of Hypertension among Persons Living with HIV in China A Multicenter Study

Fan

guo

Hsieh

et al. 2020

Preprint

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Objectives Life expectancy among persons living with HIV (PLWH) has improved with increasing access to antiretroviral therapy (ART), however incidence of chronic comorbidities has simultaneously increased. No data are available regarding the incidence of hypertension among Chinese PLWH.Methods We analyzed data collected from patients enrolled in two prospective longitudinal multicenter studies of PLWH initiating ART in China. Incidence rate of hypertension per 100 person-years (PYs) among PLWH was calculated, and Cox proportional hazards models was used to evaluate the association between incident hypertension and traditional and HIV-associated risk factors.Results Of 1078 patients included in this analysis, 984 ART-naïve patients were hypertension-free at baseline, and contributed 2337.7 PYs of follow up, with a median follow-up period of 1.8 years (range: 1.2-3.2) after initiation of ART. Incidence of hypertension was 7.6 [95% confidence interval (CI): 6.5-8.7] per 100 PYs. In the Cox regression analysis, incidence of hypertension was positively associated with BMI [adjusted hazard ratio (aHR) 1.07 (1.01,1.13), p=0.02] and recent viral load (aHR 1.28, 95% CI:1.08-1.51, p=0), and negatively associated with recent CD4+/CD8+ ratio (aHR 0.14, 95% CI:0.06-0.31, p<0.001), zidovudine exposure (aHR 0.15, 95% CI: 0.10-0.24, p<0.001) and tenofovir exposure (aHR 0.13, 95% CI: 0.08-0.21, p<0.001).Conclusions The incidence of hypertension was relatively high among Chinese PLWH initiating ART. Independent risk factors for incident hypertension included recent low CD4+/CD8+ ratio and detectable HIV viremia, whereas receipt of ART was associated with reduced risk. Hypertension may be mitigated, in part, by excellent HIV care, including viral suppression with ART.

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Hypertension and antihypertensive treatment in HIV-infected individuals. A longitudinal cohort study

Cited by 29 publications

References 163 publications

Low Nadir CD4 Cell Count Predicts Sustained Hypertension in HIV‐Infected Individuals

Low Nadir CD4 Cell Count Predicts Sustained Hypertension in HIV‐Infected Individuals

Incidence and predictors of hypertension in adults with HIV-initiating antiretroviral therapy in south-western Uganda

Incidence of Hypertension among Persons Living with HIV in China A Multicenter Study

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