Department of Cardiovascular Sciences, Louisiana State University Health Shreveport, Shreveport, Louisiana.
Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.
AIDS Res Hum Retroviruses. 2024 Apr;40(4):223-234. doi: 10.1089/AID.2022.0063. Epub 2023 Sep 7.
The prevalence and control of hypertension (HTN) among people with HIV (PWH) have not been widely studied since the release of newer 2017 ACC/AHA guidelines ("new guidelines"). To address this research gap, we evaluated and compared the prevalence and control of HTN using both 2003 JNC 7 ("old guidelines") and new guidelines. We identified 3,206 PWH with HTN from the DC Cohort study in Washington, DC, between January 2018 and June 2019. We defined HTN using International Classification of Diseases (ICD)-9/-10 diagnosis codes for HTN or ≥2 blood pressure (BP) measurements obtained at least 1 month apart (>139/89 mm Hg per old or >129/79 mm Hg per new guidelines). We defined HTN control based on recent BP (≤129/≤79 mm Hg per new guidelines). We identified socio-demographics, cardiovascular risk factors, and co-morbidities associated with HTN control using multivariable logistic regression [adjusted odds ratio (aOR); 95% confidence interval (CI)]. The prevalence of HTN was 50.9% per old versus 62.2% per new guidelines. Of the 3,206 PWH with HTN, 887 (27.7%) had a recent BP ≤129/≤79 mm Hg, 1,196 (37.3%) had a BP 130-139/80-89 mm Hg, and 1,123 (35.0%) had a BP ≥140/≥90 mm Hg. After adjusting for socio-demographics, cardiovascular risk factors, and co-morbidities, factors associated with HTN control included age 60-69 (vs. <40) years (aOR: 1.42; 95% CI: 1.03-1.98), Hispanic (vs. non-Hispanic Black) race/ethnicity (aOR 1.49; 95% CI: 1.04-2.15), receipt of HIV care at a hospital-based (vs. community-based) clinic (aOR 1.21; 95% CI: 1.00-1.47), being unemployed (aOR 1.42; 95% CI: 1.11-1.83), and diabetes (aOR 1.35; 95% CI: 1.13-1.63). In a large urban cohort of PWH, nearly two-thirds had HTN and less than one-third of those met new guideline criteria. Our data suggest that more aggressive HTN control is warranted among PWH, with additional attention to younger patients and non-Hispanic Black patients.
在较新的 2017 年 ACC/AHA 指南（“新指南”）发布后，针对艾滋病毒感染者（PWH）中高血压（HTN）的患病率和控制情况尚未进行广泛研究。为了弥补这一研究空白，我们使用 2003 年 JNC 7（“旧指南”）和新指南评估和比较了 HTN 的患病率和控制情况。我们从华盛顿特区的 DC 队列研究中确定了 3206 名患有 HTN 的 PWH，时间范围为 2018 年 1 月至 2019 年 6 月。我们使用国际疾病分类（ICD）-9/-10 高血压诊断代码或至少相隔 1 个月（>139/89 mm Hg 按旧指南或>129/79 mm Hg 按新指南）获得的≥2 次血压（BP）测量值来定义 HTN。我们根据最近的 BP（新指南中≤129/≤79 mm Hg）来定义 HTN 控制情况。我们使用多变量逻辑回归识别与 HTN 控制相关的社会人口统计学、心血管危险因素和合并症[调整后的优势比（aOR）；95%置信区间（CI）]。按旧指南，HTN 的患病率为 50.9%，而按新指南为 62.2%。在 3206 名患有 HTN 的 PWH 中，有 887 人（27.7%）最近的 BP≤129/≤79 mm Hg，1196 人（37.3%）的 BP 为 130-139/80-89 mm Hg，1123 人（35.0%）的 BP≥140/≥90 mm Hg。在调整了社会人口统计学、心血管危险因素和合并症后，与 HTN 控制相关的因素包括 60-69 岁（<40 岁）年龄（aOR：1.42；95% CI：1.03-1.98）、西班牙裔（与非西班牙裔黑人相比）种族/民族（aOR 1.49；95% CI：1.04-2.15）、在医院（与社区）诊所接受 HIV 护理（aOR 1.21；95% CI：1.00-1.47）、失业（aOR 1.42；95% CI：1.11-1.83）和糖尿病（aOR 1.35；95% CI：1.13-1.63）。在一个大型城市 PWH 队列中，近三分之二的人患有 HTN，只有不到三分之一的人符合新指南标准。我们的数据表明，PWH 需要更积极地控制 HTN，尤其是年轻患者和非西班牙裔黑人患者。
