Mongo Bua Grace, Ssempijja Victor, Ndyanabo Anthony, Nabukalu Dorean, Basiima Jesca, Kankaka Edward Nelson, Nalugoda Fred, Nakigozi Gertrude, Kagaayi Joseph, Chang Larry W, Post Wendy S, Quinn Thomas C, Gray Ron, Wawer Maria, Kigozi Godfrey, Reynolds Steven J
Rakai Health Sciences Program, Kalisizo, Uganda.
Makerere University School of Public Health, Kampala, Uganda.
BMC Infect Dis. 2025 Jul 1;25(1):860. doi: 10.1186/s12879-025-11004-3.
While antiretroviral therapy (ART) reduces AIDS-related morbidity and mortality, it is unclear if prolonged ART use among people living with HIV (PLHIV) increases the risk of hypertension.
We assessed the association between the duration of ART use and hypertension in the Rakai Community Cohort Study (RCCS).
We conducted a cross-sectional study among PLHIV (35-49 years old) on ART in the RCCS who were surveyed between August 2016 and May 2018.
Systolic and diastolic blood pressure (BP) was measured twice, averaged, and classified as any hypertension (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg), severe or worse hypertension (systolic BP ≥ 160 mmHg or diastolic BP ≥ 100 mmHg), or hypertensive crisis (systolic BP ≥ 180 mmHg or diastolic BP ≥ 110 mmHg). ART duration was categorized as short (0-2 years), moderate (> 2-5 years), or prolonged (> 5 years). We used log-binomial regression to estimate the adjusted prevalence ratio (adjPR) of hypertension associated with ART duration.
A total of 1,144 PLHIV on ART with documented BP information were identified in the RCCS, of whom 173 (15.1%) had any hypertension, 64 (5.6%) had at least severe hypertension, and 44 (3.8%) had hypertensive crisis. After controlling for age, sex, and body mass index, the prevalence of having all stages of high BP was increased by at least 42% in participants with more than five years of ART use (any hypertension adjPRs = 1.42 [95% CI = 0.99-2.03]; severe hypertension adjPRs = 1.79 [95% CI = 1.01-3.15]; and hypertensive crisis adjPRs = 2.56 [95% CI = 1.14-5.77]).
PLHIV on long-term ART have a higher burden of hypertension, highlighting the need for enhanced screening and integrated management in HIV programs.
虽然抗逆转录病毒疗法（ART）可降低与艾滋病相关的发病率和死亡率，但目前尚不清楚艾滋病毒感染者（PLHIV）长期使用ART是否会增加患高血压的风险。
在拉凯社区队列研究（RCCS）中，我们评估了ART使用时长与高血压之间的关联。
我们对2016年8月至2018年5月期间在RCCS接受ART治疗的35至49岁PLHIV进行了一项横断面研究。
测量收缩压和舒张压（BP）两次，取平均值，并将其分类为任何高血压（收缩压≥140 mmHg或舒张压≥90 mmHg）、重度或更严重高血压（收缩压≥160 mmHg或舒张压≥100 mmHg）或高血压危象（收缩压≥180 mmHg或舒张压≥110 mmHg）。ART使用时长分为短（0至2年）、中等（>2至五年）或长（>5年）。我们使用对数二项回归来估计与ART使用时长相关的高血压调整患病率比（adjPR）。
在RCCS中，共识别出1144名有记录血压信息的接受ART治疗的PLHIV，其中173人（15.1%）患有任何高血压，64人（5.6%）患有至少重度高血压，44人（3.8%）患有高血压危象。在控制年龄、性别和体重指数后，使用ART超过五年的参与者中，所有高血压阶段的患病率至少增加了42%（任何高血压adjPRs = 1.42 [95% CI = 0.99 - 2.03]；重度高血压adjPRs = 1.79 [95% CI = 1.01 - 3.15]；高血压危象adjPRs = 2.56 [95% CI = 1.14 - 5.77]）。
长期接受ART治疗的PLHIV高血压负担更高，这突出表明在艾滋病毒项目中需要加强筛查和综合管理。
