Cargando…

Prevalence of Systemic Hypertension Among HIV-Infected and HIV-Uninfected Young Adults

BACKGROUND: Advances in HIV care and treatment have resulted in perinatally infected children aging into adulthood. These patients may be at higher risk of HIV-associated non-AIDS conditions, including systemic hypertension (HTN). This study examined the association between HIV infection and the pre...

Descripción completa

Detalles Bibliográficos
Autores principales: Ryscavage, Patrick, Still, William, Nyemba, Vimbai, Stafford, Kristen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5632052/
http://dx.doi.org/10.1093/ofid/ofx162.138
_version_ 1783269622907142144
author Ryscavage, Patrick
Still, William
Nyemba, Vimbai
Stafford, Kristen
author_facet Ryscavage, Patrick
Still, William
Nyemba, Vimbai
Stafford, Kristen
author_sort Ryscavage, Patrick
collection PubMed
description BACKGROUND: Advances in HIV care and treatment have resulted in perinatally infected children aging into adulthood. These patients may be at higher risk of HIV-associated non-AIDS conditions, including systemic hypertension (HTN). This study examined the association between HIV infection and the prevalence of HTN among young adults receiving care in West Baltimore. METHODS: We conducted a cross-sectional study of young adults with perinatally-acquired (PA) HIV frequency matched on race and sex to a stratified random sample of young adults with non perinatally-acquired (NPA) HIV and HIV-uninfected young adults (UI). All subjects were aged 18–29 years of age as of September 1, 2014. The outcome of HTN was ascertained through chart review (two systolic blood pressure measurements > = 140 mmHg or diastolic > = 90 mmHg at least three months apart; and/or physician prescription for an antihypertensive mediation). Logistic regression was used to estimate adjusted prevalence odds ratios (aPOR) and 95% confidence intervals (CI) for the association between HIV infection and HTN. All data were collected from clinics within the University of Maryland Medical System. RESULTS: Three hundred and twenty-four patients were included in the study, 108 per exposure group. The prevalence of HTN was 23% among PA patients, 10% among NPA patients, and 9% among UI patients. The median age was 24 (IQR 22 - 26), 95% were African American, and 42% were male. PA patients had the highest prevalence of chronic kidney disease (CKD) and dyslipidemia (19% and 13% respectively) compared with NPA (1% and 3%) and UI (0% and 5%). PA patients had 3 (95% CI 1.4 - 6.6) times the base odds (controlling for matching variables) of prevalent HTN compared with UI patients and NPA had 1.1 times the base odds (95% CI 0.5 - 2.7) compared with UI patients. After controlling for race, gender, family history of HTN, and CKD, the prevalence odds ratio for HTN was 2.7 (95% CI 1.06 - 7.0) times higher for PA compared with UI, and 1.3 (95% CI 0.5 - 3.4) times higher for NPA compared with UI. CONCLUSION: Our findings suggest that the prevalence of HTN among young adults with PA HIV is significantly higher than sex and race matched UI patients of similar age. HIV providers should carefully monitor these patients for the development of HTN, particularly as they enter adulthood. DISCLOSURES: All authors: No reported disclosures.
format Online
Article
Text
id pubmed-5632052
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-56320522017-11-07 Prevalence of Systemic Hypertension Among HIV-Infected and HIV-Uninfected Young Adults Ryscavage, Patrick Still, William Nyemba, Vimbai Stafford, Kristen Open Forum Infect Dis Abstracts BACKGROUND: Advances in HIV care and treatment have resulted in perinatally infected children aging into adulthood. These patients may be at higher risk of HIV-associated non-AIDS conditions, including systemic hypertension (HTN). This study examined the association between HIV infection and the prevalence of HTN among young adults receiving care in West Baltimore. METHODS: We conducted a cross-sectional study of young adults with perinatally-acquired (PA) HIV frequency matched on race and sex to a stratified random sample of young adults with non perinatally-acquired (NPA) HIV and HIV-uninfected young adults (UI). All subjects were aged 18–29 years of age as of September 1, 2014. The outcome of HTN was ascertained through chart review (two systolic blood pressure measurements > = 140 mmHg or diastolic > = 90 mmHg at least three months apart; and/or physician prescription for an antihypertensive mediation). Logistic regression was used to estimate adjusted prevalence odds ratios (aPOR) and 95% confidence intervals (CI) for the association between HIV infection and HTN. All data were collected from clinics within the University of Maryland Medical System. RESULTS: Three hundred and twenty-four patients were included in the study, 108 per exposure group. The prevalence of HTN was 23% among PA patients, 10% among NPA patients, and 9% among UI patients. The median age was 24 (IQR 22 - 26), 95% were African American, and 42% were male. PA patients had the highest prevalence of chronic kidney disease (CKD) and dyslipidemia (19% and 13% respectively) compared with NPA (1% and 3%) and UI (0% and 5%). PA patients had 3 (95% CI 1.4 - 6.6) times the base odds (controlling for matching variables) of prevalent HTN compared with UI patients and NPA had 1.1 times the base odds (95% CI 0.5 - 2.7) compared with UI patients. After controlling for race, gender, family history of HTN, and CKD, the prevalence odds ratio for HTN was 2.7 (95% CI 1.06 - 7.0) times higher for PA compared with UI, and 1.3 (95% CI 0.5 - 3.4) times higher for NPA compared with UI. CONCLUSION: Our findings suggest that the prevalence of HTN among young adults with PA HIV is significantly higher than sex and race matched UI patients of similar age. HIV providers should carefully monitor these patients for the development of HTN, particularly as they enter adulthood. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2017-10-04 /pmc/articles/PMC5632052/ http://dx.doi.org/10.1093/ofid/ofx162.138 Text en © The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Ryscavage, Patrick
Still, William
Nyemba, Vimbai
Stafford, Kristen
Prevalence of Systemic Hypertension Among HIV-Infected and HIV-Uninfected Young Adults
title Prevalence of Systemic Hypertension Among HIV-Infected and HIV-Uninfected Young Adults
title_full Prevalence of Systemic Hypertension Among HIV-Infected and HIV-Uninfected Young Adults
title_fullStr Prevalence of Systemic Hypertension Among HIV-Infected and HIV-Uninfected Young Adults
title_full_unstemmed Prevalence of Systemic Hypertension Among HIV-Infected and HIV-Uninfected Young Adults
title_short Prevalence of Systemic Hypertension Among HIV-Infected and HIV-Uninfected Young Adults
title_sort prevalence of systemic hypertension among hiv-infected and hiv-uninfected young adults
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5632052/
http://dx.doi.org/10.1093/ofid/ofx162.138
work_keys_str_mv AT ryscavagepatrick prevalenceofsystemichypertensionamonghivinfectedandhivuninfectedyoungadults
AT stillwilliam prevalenceofsystemichypertensionamonghivinfectedandhivuninfectedyoungadults
AT nyembavimbai prevalenceofsystemichypertensionamonghivinfectedandhivuninfectedyoungadults
AT staffordkristen prevalenceofsystemichypertensionamonghivinfectedandhivuninfectedyoungadults