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Time trend in hypertension prevalence, awareness, treatment, and control in a contemporary cohort of HIV-infected patients: the HIV and Hypertension Study.

Abstract：

BACKGROUND:Hypertension control is often inadequate in HIV patients. In a contemporary, nationwide cohort of Italian HIV-infected adults, we assessed time trends in hypertension prevalence, awareness, treatment, and control. We also evaluated predictors of cardiovascular events and of new-onset hypertension. METHODS:Multicenter prospective cohort study, sampling 961 consecutive HIV patients (71% men, mean age 46 ± 9 years, 30% hypertensive) examined in 2010-2014 and after a median follow-up of 3.4 years. RESULTS:Among hypertensive patients, hypertension awareness (63% at baseline and 92% at follow-up), treatment (54 vs. 79%), and control (35 vs. 59%) all improved during follow-up. The incidence of new-onset hypertension was 50.1/1000 person-years (95% confidence interval, 41.2-60.3). Multivariable-adjusted predictors of hypertension were age, BMI, estimated cardiovascular risk, blood pressure, and advanced HIV clinical stage.In total, 35 new cardiovascular events were reported during follow-up (11.1/1000 person-years). In a multivariate model, baseline cardiovascular risk and hypertensive status predicted incident cardiovascular events, whereas a higher CD4 cell count had a protective role. In treated hypertensive patients, the use of integrase strand transfer inhibitors at follow-up was associated with a lower SBP (average yearly change, -3.8 ± 1.6 vs. -0.9 ± 0.5 mmHg in integrase strand transfer inhibitor users vs. nonusers, respectively, P = 0.02). CONCLUSION:Hypertension awareness, treatment, and control rates all improved in adult Italian HIV patients over the last few years, although hypertension remains highly prevalent (41%) in middle-aged HIV patients, and significantly impacts cardiovascular morbidity. Traditional risk factors and advanced HIV disease predict new-onset hypertension, whereas CD4 cell count favorably affects future cardiovascular events.

journal_name

J Hypertens

journal_title

Journal of hypertension

authors

De Socio GV,Ricci E,Maggi P,Parruti G,Celesia BM,Orofino G,Madeddu G,Martinelli C,Menzaghi B,Taramasso L,Bonfanti P,Pucci G,Schillaci G,CISAI study group.

doi

10.1097/HJH.0000000000001150

subject

Has Abstract

pub_date

2017-02-01 00:00:00

pages

409-416

issue

eissn

0263-6352

issn

1473-5598

pii

00004872-201702000-00029

journal_volume

pub_type

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Time trend in hypertension prevalence, awareness, treatment, and control in a contemporary cohort of HIV-infected patients: the HIV and Hypertension Study.