Original Article

Prevalence of Systemic Hypertension Among HIV-Infected and HIV-Uninfected Young Adults in Baltimore, Maryland

Authors: Patrick Ryscavage, MD, William Still, MS, Vimbai Nyemba, MD, Kristen Stafford, PhD

Abstract

Objectives: Adults with perinatally acquired human immunodeficiency virus (PHIV) infection may be at increased risk for nonacquired immunodeficiency syndrome (AIDS) diseases, including systemic hypertension (HTN). The purpose of this study was to examine the prevalence of HTN among young adults with PHIV compared with recently infected and uninfected young adults.

Methods: We conducted a cross-sectional study of young adults with PHIV, frequency matched on race and sex to a stratified random sample of young adults with nonperinatally acquired HIV (NPHIV) and HIV-uninfected young adults. All of the subjects were aged 18 to 29 years. HTN was defined as two systolic blood pressure measurements ≥140 mm Hg or diastolic ≥90 mm Hg at least 3 months apart and/or prescription for an antihypertensive medication. Logistic regression was used to estimate adjusted prevalence odds ratios and 95% confidence intervals (CIs) for the association between HIV infection and HTN.

Results: A total of 324 patients were included—108 per exposure group. The prevalence of HTN was 23% among individuals with PHIV, 10% among individuals with NPHIV, and 8% among HIV-uninfected patients. PHIV patients had 3.4 (95% CI 1.48–7.66) times the base odds of having HTN compared with HIV-uninfected patients, and 2.7 (95% CI 1.23–5.71) times the odds compared with NPHIV patients. By multivariable analysis, PHIV patients had 4.7 and 2.9 times the odds of having HTN compared with HIV-uninfected patients and NPHIV patients, respectively, after controlling for sex, race, and family history of hypertension.

Conclusions: Our findings suggest that HTN prevalence among PHIV young adults is significantly higher than sex- and race-matched NPHIV and HIV-uninfected patients of similar age.
Posted in: Infectious Disease136 Acquired Immunodeficiency Syndrome (AIDS) And Human Immunodeficiency Virus (HIV) Infection17

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Mirani G, Williams PL, Chernoff M, et al. Changing trends in complications and mortality rates among US youth and young adults with HIV infection in the era of combination antiretroviral therapy. Clin Infect Dis 2015;61:1850-1861.
2. Purswani MU, Chernoff MC, Mitchell CD, et al. Chronic kidney disease associated with perinatal HIV infection in children and adolescents. Pediatr Nephrol 2012;27:981-989.
3. Tandon R, Giret MT, Sengupta D, et al. Age-related expansion of Tim-3 expressing T cells in vertically HIV-1 infected children. PLoS One 2012;7:e45733.
4. Sims A, Hadigan C. Cardiovascular complications in children with HIV infection. Curr HIV/AIDS Rep 2011;8:209-214.
5. Charakida M, Loukogeorgakis SP, Okorie MI, et al. Increased arterial stiffness in HIV-infected children: risk factors and antiretroviral therapy. Antivir Ther 2009;14:1075-1079.
6. Nguyen QC, Tabor JW, Entzel PP, et al. Discordance in national estimates of hypertension among young adults. Epidemiology 2011;22:532-541.
7. De Socio GV, Ricci E, Maggi P, et al. Prevalence, awareness, treatment, and control rate of hypertension in HIV-infected patients: the HIV-HY study. Am J Hypertens 2014;27:222-228.
8. Savès M, Chêne G, Ducimetière P, et al. Risk factors for coronary heart disease in patients treated for human immunodeficiency virus infection compared with the general population. Clin Infect Dis 2003;37:292-298.
9. Gazzaruso C, Bruno R, Garzaniti A, et al. Hypertension among HIV patients: prevalence and relationships to insulin resistance and metabolic syndrome. J Hypertens 2003;21:1377-1382.
10. Bergersen BM, Sandvik L, Dunlop O, et al. Prevalence of hypertension in HIV-positive patients on highly active retroviral therapy (HAART) compared with HAART-naï and HIV-negative controls: results from a Norwegian study of 721 patients. Eur J Clin Microbiol Infect Dis 2003;22:731-736.
11. Baekken M, Os I, Sandvik L, et al. Hypertension in an urban HIV-positive population compared with the general population: influence of combination antiretroviral therapy. J Hypertens 2008;26:2126-2133.
12. Krauskopf K, Van Natta ML, Danis RP, et al. Correlates of hypertension in patients with AIDS in the era of highly active antiretroviral therapy. J Int Assoc Provid AIDS Care 2013;12:325-333.
13. Seaberg EC, Muñoz A, Lu M, et al. Association between highly active antiretroviral therapy and hypertension in a large cohort of men followed from 1984 to 2003. AIDS 2005;19:953-960.
14. van Zoest RA, van den Born BH, Reiss P. Hypertension in people living with HIV. Curr Opin HIV AIDS 2017;12:513-522.
15. Hejazi N, Huang MS, Lin KG, et al. Hypertension among HIV-infected adults receiving highly active antiretroviral therapy (HAART) in Malaysia. Glob J Health Sci 2013;6:58-71.
16. Ryscavage P, Macharia T, Trinidad LR, et al. Patterns of systemic hypertension among adults with perinatally acquired HIV. J Int Assoc Provid AIDS Care 2017;16:3-7.
17. Valeri L, VanderWeele TJ. Mediation analysis allowing for exposure-mediator interactions and causal interpretation: theoretical assumptions and implementation with SAS and SPSS macros. Psychol Methods 2013;18:137-150.
18. Gooding HC, McGinty S, Richmond TK, et al. Hypertension awareness and control among young adults in the national longitudinal study of adolescent health. J Gen Intern Med 2014;29:1098-1104.
19. Calò LA, Caielli P, Maiolino G, Rossi G. Arterial hypertension and cardiovascular risk in HIV-infected patients. J Cardiovasc Med (Hagerstown) 2013;14:553-558.