Department of Epidemiology.
Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
AIDS. 2023 Mar 15;37(4):679-688. doi: 10.1097/QAD.0000000000003461. Epub 2022 Dec 23.
Hypertension is a critical cause of cardiovascular disease, and women with HIV have a higher prevalence of hypertension than women without HIV. The relationship between hypertension and mortality has not been well characterized in women with treated HIV. Here, we estimate the effect of hypertension on 1-year risk of all-cause mortality among women with HIV on antiretroviral therapy (ART) in the United States.
An analysis of multicenter, observational cohort data from the Women's Interagency HIV Study (WIHS) collected between 1995 and 2019.
We included women with HIV who reported ever using ART. We used parametric g-computation to estimate the effect of hypertension (SBP ≥140 mmHg, DBP ≥90 mmHg, or use of hypertensive medication) on all-cause mortality within 1 year of a WIHS visit.
Among 2929 unique women, we included 57 034 visits with a median age of 45 (interquartile range: 39, 52) years. Women had hypertension at 34.5% of visits, and 641 deaths occurred within 1 year of a study visit. Comparing women at visits with hypertension to women at visits without hypertension, the standardized 1-year risk ratio for mortality was 1.16 [95% confidence interval (95% CI): 1.01-1.33]. The risk ratios were higher in Hispanic (risk ratio: 1.23, 95% CI: 0.86-1.77) and non-Hispanic black women (risk ratio: 1.19, 95% CI: 1.04-1.37) and lower in non-Hispanic white women (risk ratio: 0.93, 95% CI: 0.58-1.48).
Among women with treated HIV, those with hypertension, compared with those without, had an increased 1-year risk of all-cause mortality.
高血压是心血管疾病的一个重要病因，而感染 HIV 的女性患高血压的比例高于未感染 HIV 的女性。在接受抗逆转录病毒疗法 (ART) 的 HIV 感染者中，高血压与死亡率之间的关系尚未得到很好的描述。在这里，我们估计高血压对美国接受抗逆转录病毒治疗的 HIV 女性的全因死亡率的 1 年风险的影响。
对 1995 年至 2019 年期间妇女艾滋病研究机构间 (WIHS) 多中心观察性队列数据进行的分析。
我们纳入了报告曾经使用过 ART 的 HIV 感染者。我们使用参数 g 计算来估计高血压（SBP ≥140mmHg，DBP ≥90mmHg，或使用降压药物）对 WIHS 就诊后 1 年内全因死亡率的影响。
在 2929 名独特的女性中，我们纳入了 57034 次就诊，中位年龄为 45 岁（四分位距：39，52）。女性在 34.5%的就诊时患有高血压，641 例死亡发生在研究就诊后 1 年内。与就诊时无高血压的女性相比，就诊时患有高血压的女性的标准化 1 年死亡率风险比为 1.16（95%可信区间[95%CI]：1.01-1.33）。在西班牙裔（风险比：1.23，95%CI：0.86-1.77）和非西班牙裔黑人女性（风险比：1.19，95%CI：1.04-1.37）中风险比更高，而非西班牙裔白人女性中风险比更低（风险比：0.93，95%CI：0.58-1.48）。
在接受治疗的 HIV 女性中，与无高血压者相比，患有高血压者的全因死亡率在 1 年内增加。
