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波兰HIV感染成人中的高血压、血脂异常及心血管风险

Hypertension, dyslipidaemia, and cardiovascular risk in HIV-infected adults in Poland.

作者信息

Rogalska-Płońska Magdalena, Rogalski Paweł, Leszczyszyn-Pynka Magdalena, Stempkowska Justyna, Kocbach Piotr, Kowalczuk-Kot Aldona, Janczarek Małgorzata, Grzeszczuk Anna

机构信息

Uniwersytet Medyczny w Białymstoku.

出版信息

Kardiol Pol. 2017;75(12):1324-1331. doi: 10.5603/KP.a2017.0148. Epub 2017 Jul 17.

Abstract

BACKGROUND

The prevalence of cardiovascular diseases (CVD) in HIV-infected patients increases with aging and duration of the disease. Hypertension, high cholesterol level obesity, diabetes, tobacco exposure, and use of alcohol are among the traditional risk factors that contribute to CVD.

AIM

The aim of the study was to determinate the incidence of hypertension, lipid disturbances, and CVD risk in dependence on clinical, viral, and biochemical factors.

METHODS

A total of 417 HIV-infected Caucasian adult patients from the four clinical centres in Poland were enrolled and analysed on the basis of available medical data from the years 2013-2015.

RESULTS

Hypertension was diagnosed in 28% of all patients and in the age ranges: < 40 years, 41-60 years and > 60 years in 18%, 43%, and 53%, respectively. The percentage of optimal, normal, and high normal blood pressure was: 28%, 14%, and 30%, respectively. Hypertension grade 1, 2, and 3 was observed in 58%, 35%, and 7% of patients, respectively. Factors associated with hypertension were: increasing age, male sex, increased body mass index, hypercholesterolaemia, hypo-high density lipoprotein (HDL), hypertriglyceridaemia and duration of HIV infection more than 10 years. Hypercholesterolaemia, suboptimal level of HDL, elevated low-density lipoprotein, and hypertriglyceridaemia were observed in 37%, 20.5%, 31%, and 52%, respectively. Hypertriglyceridaemia was associated with protease inhibitor-based highly active antiretroviral therapy. HCV infection was negatively associated with hypercholesterolaemia. Cigarette smoking was reported in 55% of cases.

CONCLUSIONS

Incidence of hypertension in particular age groups of HIV infected people is higher than in the general Polish population. Hypertension is influenced by traditional risk factors and duration of HIV infection but not antiretroviral treatment. HIV/HCV coinfection appears to be protective against hypercholesterolaemia.

摘要

背景

心血管疾病(CVD)在HIV感染患者中的患病率随年龄增长和疾病持续时间增加。高血压、高胆固醇水平、肥胖、糖尿病、烟草暴露和饮酒是导致心血管疾病的传统危险因素。

目的

本研究的目的是确定高血压、血脂紊乱和心血管疾病风险的发生率与临床、病毒和生化因素的相关性。

方法

来自波兰四个临床中心的417名感染HIV的白种成年患者被纳入研究,并根据2013 - 2015年的可用医疗数据进行分析。

结果

所有患者中28%被诊断为高血压,在年龄范围<40岁、41 - 60岁和>60岁的患者中,分别有18%、43%和53%患有高血压。血压处于最佳、正常和高正常水平的百分比分别为:28%、14%和30%。分别有58%、35%和7%的患者观察到1级、2级和3级高血压。与高血压相关的因素有:年龄增长、男性、体重指数增加、高胆固醇血症、低高密度脂蛋白(HDL)、高甘油三酯血症以及HIV感染持续时间超过10年。高胆固醇血症、HDL水平欠佳、低密度脂蛋白升高和高甘油三酯血症的发生率分别为37%、20.5%、31%和52%。高甘油三酯血症与基于蛋白酶抑制剂的高效抗逆转录病毒治疗有关。丙型肝炎病毒(HCV)感染与高胆固醇血症呈负相关。55%的病例报告有吸烟情况。

结论

特定年龄组的HIV感染者中高血压的发生率高于波兰普通人群。高血压受传统危险因素和HIV感染持续时间影响,但不受抗逆转录病毒治疗影响。HIV/HCV合并感染似乎对高胆固醇血症有保护作用。

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