Bauer Sophie, Wa Mwanza Mwanza, Chilengi Roma, Holmes Charles B, Zyambo Zude, Furrer Hansjakob, Egger Matthias, Wandeler Gilles, Vinikoor Michael J
a Department of Infectious Diseases , Bern University Hospital, University of Bern , Bern , Switzerland.
b Centre for Infectious Diseases Research in Zambia , Lusaka , Zambia.
Glob Health Action. 2017;10(1):1359923. doi: 10.1080/16549716.2017.1359923.
The prevalence of high blood pressure (HBP) and hypertension (HTN), awareness of the diagnoses, and use of anti-hypertensive drugs were examined among human immunodeficiency virus (HIV)-infected individuals on antiretroviral therapy (ART) in Zambia's capital Lusaka. Within a prospective cohort based at two public sector ART clinics, BP was measured at ART initiation and every 6 months thereafter as a routine clinic procedure. Predictors of HBP (systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg) during one year on ART were analyzed using logistic regression, and the proportion with HTN (2+ episodes of HBP >3 months apart) described. A phone survey was used to understand patient awareness of HBP, use of anti-hypertensive drugs, and history of cardiovascular events (CVE; myocardial infarction or stroke). Among 896 cohort participants, 887 (99.0%) had at least one BP measurement, 98 (10.9%) had HBP, and 57 (6.4%) had HTN. Increasing age (10-year increase in age: adjusted odds ratio [AOR] = 1.50; 95% confidence interval [CI] 1.20-1.93), male sex (AOR = 2.33, 95% CI 1.43-3.80), and overweight/obesity (AOR = 4.07; 95% CI 1.94-8.53) were associated with HBP. Among 66 patients with HBP, 35 (53.0%) reported awareness of the condition, and nine (25.7%) of these reported having had a CVE. Only 14 (21.2%) of those reached reported ever taking an anti-hypertensive drug, and one (1.5%) was currently on treatment. These data suggest that major improvements are needed in the management of HBP among HIV-infected individuals in settings such as Zambia.
在赞比亚首都卢萨卡，对接受抗逆转录病毒治疗（ART）的人类免疫缺陷病毒（HIV）感染者进行了高血压（HBP）和高血压（HTN）的患病率、诊断知晓率以及抗高血压药物使用情况的调查。在两个公共部门ART诊所的前瞻性队列中，在开始ART时以及此后每6个月测量一次血压，作为常规临床程序。使用逻辑回归分析了ART治疗一年期间HBP（收缩压≥140mmHg或舒张压≥90mmHg）的预测因素，并描述了HTN（间隔超过3个月的HBP发作2次以上）的比例。通过电话调查了解患者对HBP的知晓情况、抗高血压药物的使用情况以及心血管事件（CVE；心肌梗死或中风）病史。在896名队列参与者中，887人（99.0%）至少进行了一次血压测量，98人（10.9%）患有HBP，57人（6.4%）患有HTN。年龄增加（年龄增加10岁：调整后的优势比[AOR]=1.50；95%置信区间[CI]1.20-1.93）、男性（AOR=2.33，95%CI 1.43-3.80）和超重/肥胖（AOR=4.07；95%CI 1.94-8.53）与HBP相关。在66名患有HBP的患者中，35人（53.0%）报告知晓病情，其中9人（25.7%）报告有CVE。在联系到的患者中，只有14人（21.2%）报告曾服用抗高血压药物，1人（1.5%）目前正在接受治疗。这些数据表明，在赞比亚等地区，HIV感染者的HBP管理需要大幅改善。
