Migisha Richard, Ario Alex Riolexus, Kadobera Daniel, Bulage Lilian, Katana Elizabeth, Ndyabakira Alex, Elyanu Peter, Kalamya Julius N, Harris Julie R
Public Health Fellowship Program, Kampala, Uganda.
Ministry of Health, Kampala, Uganda.
Clin Hypertens. 2023 Apr 15;29(1):6. doi: 10.1186/s40885-022-00230-5.
High blood pressure (HBP), including hypertension (HTN), is a predictor of cardiovascular events, and is an emerging challenge in young persons. The risk of cardiovascular events may be further amplified among people living with HIV (PLHIV). We determined the prevalence of HBP and associated factors among PLHIV aged 13 to 25 years in Rwenzori region, western Uganda.
We conducted a cross-sectional study among PLHIV aged 13 to 25 years at nine health facilities in Kabarole and Kasese districts during September 16 to October 15, 2021. We reviewed medical records to obtain clinical and demographic data. At a single clinic visit, we measured and classified BP as normal (< 120/ < 80 mmHg), elevated (120/ < 80 to 129/ < 80), stage 1 HTN (130/80 to 139/89), and stage 2 HTN (≥ 140/90). We categorized participants as having HBP if they had elevated BP or HTN. We performed multivariable analysis using modified Poisson regression to identify factors associated with HBP.
Of the 1,045 PLHIV, most (68%) were female and the mean age was 20 (3.8) years. The prevalence of HBP was 49% (n = 515; 95% confidence interval [CI], 46%-52%), the prevalence of elevated BP was 22% (n = 229; 95% CI, 26%-31%), and the prevalence of HTN was 27% (n = 286; 95% CI, 25%-30%), including 220 (21%) with stage 1 HTN and 66 (6%) with stage 2 HTN. Older age (adjusted prevalence ratio [aPR], 1.21; 95% CI, 1.01-1.44 for age group of 18-25 years vs. 13-17 years), history of tobacco smoking (aPR, 1.41; 95% CI, 1.08-1.83), and higher resting heart rate (aPR, 1.15; 95% CI, 1.01-1.32 for > 76 beats/min vs. ≤ 76 beats/min) were associated with HBP.
Nearly half of the PLHIV evaluated had HBP, and one-quarter had HTN. These findings highlight a previously unknown high burden of HBP in this setting's young populations. HBP was associated with older age, elevated resting heart rate, and ever smoking; all of which are known traditional risk factors for HBP in HIV-negative persons. To prevent future cardiovascular disease epidemics among PLHIV, there is a need to integrate HBP/HIV management.
高血压（HBP），包括高血压（HTN），是心血管事件的一个预测指标，并且在年轻人中是一个新出现的挑战。在感染艾滋病毒者（PLHIV）中，心血管事件的风险可能会进一步放大。我们确定了乌干达西部鲁文佐里地区13至25岁PLHIV中HBP的患病率及相关因素。
2021年9月16日至10月15日期间，我们在卡巴罗莱区和卡塞塞区的9个医疗机构对13至25岁的PLHIV进行了一项横断面研究。我们查阅医疗记录以获取临床和人口统计学数据。在单次门诊就诊时，我们测量血压并将其分类为正常（<120/<80 mmHg）、血压升高（120/<80至129/<80）、1级高血压（130/80至139/89）和2级高血压（≥140/90）。如果参与者血压升高或患有高血压，我们将其归类为患有HBP。我们使用修正泊松回归进行多变量分析，以确定与HBP相关的因素。
在1045名PLHIV中，大多数（68%）为女性，平均年龄为20（3.8）岁。HBP的患病率为49%（n = 515；95%置信区间[CI]，46%-52%），血压升高的患病率为22%（n = 229；95% CI，26%-31%），高血压的患病率为27%（n = 286；95% CI，25%-30%），包括220名（21%）1级高血压患者和66名（6%）2级高血压患者。年龄较大（调整患病率比[aPR]，1.21；18-25岁年龄组与13-17岁年龄组相比，95% CI，1.01-1.44）、有吸烟史（aPR，1.41；95% CI，1.08-1.83）以及静息心率较高（>76次/分钟与≤76次/分钟相比，aPR，1.15；95% CI，1.01-1.32）与HBP相关。
近一半接受评估的PLHIV患有HBP，四分之一患有高血压。这些发现凸显了在该环境下年轻人群中以前未知的HBP高负担。HBP与年龄较大、静息心率升高和曾经吸烟有关；所有这些都是已知的HIV阴性人群中HBP的传统风险因素。为了预防PLHIV未来的心血管疾病流行，有必要整合HBP/HIV管理。
