Bigna Jean Joel, Ndoadoumgue Aude Laetitia, Nansseu Jobert Richie, Tochie Joel Noutakdie, Nyaga Ulrich Flore, Nkeck Jan René, Foka Audrey Joyce, Kaze Arnaud D, Noubiap Jean Jacques
Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, Yaoundé, Cameroon.
School of Health and Related Research, The University of Sheffield, Sheffield, UK.
J Hypertens. 2020 Sep;38(9):1659-1668. doi: 10.1097/HJH.0000000000002446.
Although HIV infection and antiretroviral therapy (ART) increase the risk for hypertension in people living with HIV (PLHIV), the global and regional burden of hypertension in PLHIV is not well characterized.
In this systematic review and meta-analysis, we searched multiple databases for studies reporting on hypertension in PLHIV and conducted between 2007 and 2018. Meta-analysis through random-effect models served to obtain the pooled prevalence estimates. Heterogeneity was assessed via the χ test on Cochran's Q statistic.
We included 194 studies (396 776 PLHIV from 61 countries). The global prevalence of hypertension was 23.6% [95% confidence interval (95% CI: 21.6-25.5)] with substantial heterogeneity. The regional distribution was Western and Central Europe and North America [28.1% (95% CI: 24.5-31.9)], West and Central Africa [23.5% (16.6-31.0)], Latin America and the Caribbean [22.0% (17.8-26.5)], Eastern and Southern Africa [19.9% (17.2-22.8)], and Asia and Pacific [16.5% (12.5-21.0)]; P = 0.0007. No study originated from the Middle East and North Africa, and Eastern Europe and Central Asia regions. The prevalence was higher in high-income countries than others (P = 0.0003) and higher in PLHIV taking ART than those ART-naive (P = 0.0003). The prevalence increased over time (mainly driven by Eastern and Southern Africa) and with age. There was no difference between men and women. We estimated that in 2018, there were 8.9 (95% CI: 8.3-9.6) million cases of hypertension in PLHIV globally, among whom 59.2% were living in Sub-Saharan Africa.
Cost-effective strategies to curb the dreadful burden of hypertension among PLHIV are needed.
尽管艾滋病毒感染和抗逆转录病毒疗法（ART）会增加艾滋病毒感染者（PLHIV）患高血压的风险，但全球和地区PLHIV中高血压的负担尚未得到充分描述。
在这项系统评价和荟萃分析中，我们在多个数据库中检索了2007年至2018年间报告PLHIV高血压情况的研究。通过随机效应模型进行荟萃分析以获得合并患病率估计值。通过对Cochran's Q统计量进行χ检验评估异质性。
我们纳入了194项研究（来自61个国家的396776名PLHIV）。高血压的全球患病率为23.6%[95%置信区间（95%CI：21.6 - 25.5）]，存在显著异质性。区域分布为西欧和中欧以及北美[28.1%（95%CI：24.5 - 31.9）]、西非和中非[23.5%（16.6 - 31.0）]、拉丁美洲和加勒比地区[22.0%（17.8 - 26.5）]、东非和南非[19.9%（17.2 - 22.8）]以及亚太地区[16.5%（12.5 - 21.0）]；P = 0.0007。没有研究来自中东和北非以及东欧和中亚地区。高收入国家的患病率高于其他国家（P = 0.0003），接受ART的PLHIV患病率高于未接受ART的PLHIV（P = 0.0003）。患病率随时间增加（主要由东非和南非推动）且随年龄增长。男女之间没有差异。我们估计，2018年全球PLHIV中有890万（95%CI：830 - 960万）高血压病例，其中59.2%生活在撒哈拉以南非洲。
需要采取具有成本效益的策略来遏制PLHIV中高血压的可怕负担。
