Factors associated with primary hypertension in HIV-infected patients on Highly Active Antiretroviral Therapy (HAART) at a District Hospital of Phuket.
Keywords:
primary hypertension, HIV, HAARTAbstract
A retrospective analytical study was designed to determine associated risk factors with primary hypertension among HIV-infected patients who were on Highly Active Antiretroviral Therapy (HAART) at a district hospital of Phuket between 1st January 2013 – 31st December 2017. Primary hypertension was defined as blood pressure ≥ 140/90 mmHg or history of recieving of antihypertensive drugs. 377 patients were enrolled. Rate of hypertension was 19.4%
(n=73). Male gender (OR: 2.91, 95% CI: 1.55-5.48; p = 0.001), body mass index (BMI) > 30 Kg/m2 (OR: 4.96, 95% CI: 1.53-16.12; p = 0.008) and years of HAART exposure > 5 years (OR: 3.09, 95% CI:1.25-7.65; p = 0.015) were independently and significantly associated with the presence of primary hypertension in HIV-infected patients at multiple logistic regression analysis. None of metabolic parameters, immunologic factors and the antiretroviral drugs was linked to primary hypertension. In conclusion hypertension among HIV-infected patients on HAART was linked to the well-known risk factors such as gender and BMI and also prolonged HAART use. With HAART, people can live longer, blood pressure and cardiovascular risk factors should be routinely monitored. Other factors such as diet, weight control and physical exercise should also be considered for maintaining quality of life.
References
1. World Health Organization. Global Health Observatory (GHO) data [online]. 2015 [cited 2018 March 12]; Available from: URL: https://www.who.int/gho/hiv/en/
2. Smith CJ, Ryom L, Weber R, Morlat P, Pradier C, Reiss P, et al. Trends in underlying causes of death in people with HIV from 1999 to 2011 (D:A:D): a multicohort collaboration. Lancet 2014; 384: 241-48.
3. World Health Organization. A global brief on Hypertension [online]. 2013 [cited 2018 March 12]; Available from: URL: http://ish-world.com/downloads/pdf/global_
brief_hypertension.pdf
4. Seaberg EC, Munoz A, Lu M, Detels R, Margolick JB, Riddler SA, et al. Association between highly active antiretroviral therapy and hypertension in a large cohort of men followed from 1984 to 2003. AIDS 2005; 19: 953-60.
5. Jerico C, Knobel H, Montero M, Sorli ML, Guelar A, Gimeno JL, et al. Hypertension in HIV-Infected Patients: Prevalence and Related Factors. AJH 2005; 18: 1396-
1401.
6. Koren M, Wallach T, Bursztyn M, Maayan S, Olshtain-Pops K. High Prevalence of Hypertension in Ethiopian and Non-Ethiopian HIV-Infected Adults. Int J Hypertens [serial online] 2018 [cited 2018 March 12]; [7 pages]. Available from:URL: https://www.hindawi.com/journalsijhy/2018/8637101/
7. Okello S, Kanyesigye M, Muyindike WR, Annex BH, Hunt PW, Haneuse S, et al. Incidence and Predictors of Hypertension in Adults with HIV Initiating Antiretroviral
Therapy in Southwestern Uganda. J Hypertens 2015; 33 (10): 2039-45.
8. Dimala CA, Atashili J, Mbuagbaw JC, Wilfred A, Monekosso GL. Prevalence of Hypertension in HIV/AIDS Patients on Highly Active Antiretroviral Therapy (HAART) Compared with HAART-Naïve Patients at the Limbe Regional Hospital, Cameroon. PLoS ONE [serial online] 2016 [cited 2018 March 12]; 11(2): [11 pages]. Available from: URL: https:// journals.plos.org/plosone/article?id= 10.1371/journal.pone.0148100
9. Olaiya O, Weiser J, Zhou W, Ptel P, Bradley H. Hypertension Among Persons Living With HIV in Medical Care in the United States-Medical Monitoring Project, 2013-2014. Open Forum Infect Dis [serial online] 2018 [cited 2018 March 12]; 5(3): [5 pages]. Available from: URL: https://academic.oup.com/ofid/article/5/3/ofy028/4830141
10. Medina-Torne S, Ganesan A, Barahona I, Crum-Cianflone NF. Hypertension is Common among HIV-Infected Persons, But Not Associated with HAART. Journal
of the International Association of Physicians in AIDS Care 2012; I I (I): 20-25.
11. Rodriguez-Arboli E, Mwamelo K, Kalinjuma AV, Furrer H, Hatz C, Tanner M, et al. Incidence and risk factors for hypertension among HIV patients in rural Tanzania – A prospective cohort study. PLoS ONE [serial online] 2017 [cited 2018 March 12]; 12(3):[14 pages]. Available from: URL: https://journals.plos.org/plosone/article?id
=10.1371/journal.pone.0172089
12. Hejazi N, MSL H, Lin KG, Choong LCK. Hypertension among HIV-Infected Adults Receiving Highly Active Antiretroviral Therapy (HAART) in Malaysia. Global Journal of Health Science 2014; 6(2): 58-70.
13. ZoestRAv, Wit FW, Kooij KW, ValkMvd, Schouten J, Kootstra NA, et al. Higher Prevalence of Hypertension in HIV-1-Infected Patients on Combination Antiretroviral Therapy Is Associated With Changes in Body Composition and Prior Stavudine Exposure. CID 2016; 63: 205-13.
14. Sattler FR, Qian D, Luie S, Johnson D, Briggs W, DeQuattro V, et al. Elevated blood pressure in subjects with lipodystrophy. AIDS 2001; 15: 2001-10.
15. Crane HM, Grunfeld C, Harrington RD, Kitahata MM. Lipoatrophy and lipohypertrophy are independently associated with hypertension. HIV Med 2009 September; 10(8): 496-503.
16. Hemkens LG, Bucher HC. HIV infection and cardiovascular disease. EHJ 2014; 35: 1373-81.
17. Wand H, Calmy A, Carey DL, Samaras K, Carr A, Law MG, et al. Metabolic syndrome, cardiovasculary disease and type 2 diabetes mellitus after initiation of antiretroviral therapy in HIV infection. AIDS 2007; 21: 2445-53.
18. Alvarez C, SalaZar R, Galindez J, Rangel F, Castaneda ML, Lopardo G, et al. Metabolic syndrome in HIVinfected patients receiving antiretroviral therapy in Latin America. (Braz) Infect Dis 2010; 14(3): 256-63.
19. Samaras K, Wand H, Law M, Emery S, Cooper D, Carr A. Prevalence of Metabolic Syndrome in HIV-Infected Patients Receiving Highly Active Antiretroviral Therapy Using International Diabetes Foundation and Adult Treatment Panel III Criteria. Diabetes Care 2007; 30: 113-9.
20. WijkJPHv, Cabezas MC. Hypert riglyceridemia, Metabolic Syndrome, and Cardiovascular Disease in HIVInfected Patients: Effects of Antiretroviral Therapy and Adipose Tissue Distribution. Int J Vasc Med [serial online] 2012 [cited 2018 March 12]; [13 pages]. Available from: URL: https:// www.hindawi.com/journals/ijvm/ 2012/201027/
21. Grinspoon S, Carr A. Cardiovascular Risk and Body-Fat Abnormalities in HIVInfected Adults. N Engl J Med 2005; 352: 48-62.
22. Dube MP, Lipshultz SE, Fichtenbaum CJ, Greenberg R, Schecter AD, Fisher SD. Effects of HIV infection and Antiretroviral Therapy on the Heart and Vasculature. Circulation 2008; 118: e36-e40.
23. Petoumenos K, Worm SW. HIV infection, aging and cardiovascular disease: epidemiology and prevention. Sex Health 2011; 8: 465-73.
24. Thailand National Guidelines on HIV/AIDS Treatment and Prevention 2017.แนวทางการตรวจรักษาและป้องกันการติดเชื้อเอชไอวีประเทศไทย ปี 2560. บทนำ.
25. วิชัย เอกพลากร, บรรณาธิการ. รายงานการสำรวจสุขภาพประชาชนไทยโดยการตรวจร่างกายครั้งที่ 5 พ.ศ. 2557. กรุงเทพมหานคร: อักษรกราฟฟิกแอนด์ดีไซน์; 2559. 149-155.
26. ศรีเพ็ญ สวัสดิมงคล, บรรณาธิการ. รายงานประจำปี 2558 สำนักโรคไม่ติดต่อ กรมควบคุมโรค กระทรวงสาธารณสุข. กรุงเทพมหานคร: สำนักงานกิจการโรงพิมพ์องค์การสงเคราะห์ทหารผ่านศึกในพระบรมราชูปถัมภ์; 2559. 11-12.
27. (Abstract) Jantarapakde J, Phanuphak N, Chaturawit C, Pengnonyang S, Mathajittiphan P, Takamtha P, et al. Prevalence of Metabolic Syndrome Among Antiretroviral-Naïve and Antiretroviral-Experienced HIV-1 Infected Thai Adults. AIDS Patient Care STDS 2014; 28(7): 331-40.
28. Santiprabhob J, Tanchaweng S, Maturapat S, Maleesatharn A, Lermankul W, Sricharoenchai S, et al. Metabolic Disorders in HIV-Infected Adolescents
Receiving Protease Inhibitors. BioMed Res Int [serial online] 2017 [cited 2018 March 12]; [14 pages]. Available from: URL: https://www.hindawi.com/ journals/bmri/2017/7481597/
2. Smith CJ, Ryom L, Weber R, Morlat P, Pradier C, Reiss P, et al. Trends in underlying causes of death in people with HIV from 1999 to 2011 (D:A:D): a multicohort collaboration. Lancet 2014; 384: 241-48.
3. World Health Organization. A global brief on Hypertension [online]. 2013 [cited 2018 March 12]; Available from: URL: http://ish-world.com/downloads/pdf/global_
brief_hypertension.pdf
4. Seaberg EC, Munoz A, Lu M, Detels R, Margolick JB, Riddler SA, et al. Association between highly active antiretroviral therapy and hypertension in a large cohort of men followed from 1984 to 2003. AIDS 2005; 19: 953-60.
5. Jerico C, Knobel H, Montero M, Sorli ML, Guelar A, Gimeno JL, et al. Hypertension in HIV-Infected Patients: Prevalence and Related Factors. AJH 2005; 18: 1396-
1401.
6. Koren M, Wallach T, Bursztyn M, Maayan S, Olshtain-Pops K. High Prevalence of Hypertension in Ethiopian and Non-Ethiopian HIV-Infected Adults. Int J Hypertens [serial online] 2018 [cited 2018 March 12]; [7 pages]. Available from:URL: https://www.hindawi.com/journalsijhy/2018/8637101/
7. Okello S, Kanyesigye M, Muyindike WR, Annex BH, Hunt PW, Haneuse S, et al. Incidence and Predictors of Hypertension in Adults with HIV Initiating Antiretroviral
Therapy in Southwestern Uganda. J Hypertens 2015; 33 (10): 2039-45.
8. Dimala CA, Atashili J, Mbuagbaw JC, Wilfred A, Monekosso GL. Prevalence of Hypertension in HIV/AIDS Patients on Highly Active Antiretroviral Therapy (HAART) Compared with HAART-Naïve Patients at the Limbe Regional Hospital, Cameroon. PLoS ONE [serial online] 2016 [cited 2018 March 12]; 11(2): [11 pages]. Available from: URL: https:// journals.plos.org/plosone/article?id= 10.1371/journal.pone.0148100
9. Olaiya O, Weiser J, Zhou W, Ptel P, Bradley H. Hypertension Among Persons Living With HIV in Medical Care in the United States-Medical Monitoring Project, 2013-2014. Open Forum Infect Dis [serial online] 2018 [cited 2018 March 12]; 5(3): [5 pages]. Available from: URL: https://academic.oup.com/ofid/article/5/3/ofy028/4830141
10. Medina-Torne S, Ganesan A, Barahona I, Crum-Cianflone NF. Hypertension is Common among HIV-Infected Persons, But Not Associated with HAART. Journal
of the International Association of Physicians in AIDS Care 2012; I I (I): 20-25.
11. Rodriguez-Arboli E, Mwamelo K, Kalinjuma AV, Furrer H, Hatz C, Tanner M, et al. Incidence and risk factors for hypertension among HIV patients in rural Tanzania – A prospective cohort study. PLoS ONE [serial online] 2017 [cited 2018 March 12]; 12(3):[14 pages]. Available from: URL: https://journals.plos.org/plosone/article?id
=10.1371/journal.pone.0172089
12. Hejazi N, MSL H, Lin KG, Choong LCK. Hypertension among HIV-Infected Adults Receiving Highly Active Antiretroviral Therapy (HAART) in Malaysia. Global Journal of Health Science 2014; 6(2): 58-70.
13. ZoestRAv, Wit FW, Kooij KW, ValkMvd, Schouten J, Kootstra NA, et al. Higher Prevalence of Hypertension in HIV-1-Infected Patients on Combination Antiretroviral Therapy Is Associated With Changes in Body Composition and Prior Stavudine Exposure. CID 2016; 63: 205-13.
14. Sattler FR, Qian D, Luie S, Johnson D, Briggs W, DeQuattro V, et al. Elevated blood pressure in subjects with lipodystrophy. AIDS 2001; 15: 2001-10.
15. Crane HM, Grunfeld C, Harrington RD, Kitahata MM. Lipoatrophy and lipohypertrophy are independently associated with hypertension. HIV Med 2009 September; 10(8): 496-503.
16. Hemkens LG, Bucher HC. HIV infection and cardiovascular disease. EHJ 2014; 35: 1373-81.
17. Wand H, Calmy A, Carey DL, Samaras K, Carr A, Law MG, et al. Metabolic syndrome, cardiovasculary disease and type 2 diabetes mellitus after initiation of antiretroviral therapy in HIV infection. AIDS 2007; 21: 2445-53.
18. Alvarez C, SalaZar R, Galindez J, Rangel F, Castaneda ML, Lopardo G, et al. Metabolic syndrome in HIVinfected patients receiving antiretroviral therapy in Latin America. (Braz) Infect Dis 2010; 14(3): 256-63.
19. Samaras K, Wand H, Law M, Emery S, Cooper D, Carr A. Prevalence of Metabolic Syndrome in HIV-Infected Patients Receiving Highly Active Antiretroviral Therapy Using International Diabetes Foundation and Adult Treatment Panel III Criteria. Diabetes Care 2007; 30: 113-9.
20. WijkJPHv, Cabezas MC. Hypert riglyceridemia, Metabolic Syndrome, and Cardiovascular Disease in HIVInfected Patients: Effects of Antiretroviral Therapy and Adipose Tissue Distribution. Int J Vasc Med [serial online] 2012 [cited 2018 March 12]; [13 pages]. Available from: URL: https:// www.hindawi.com/journals/ijvm/ 2012/201027/
21. Grinspoon S, Carr A. Cardiovascular Risk and Body-Fat Abnormalities in HIVInfected Adults. N Engl J Med 2005; 352: 48-62.
22. Dube MP, Lipshultz SE, Fichtenbaum CJ, Greenberg R, Schecter AD, Fisher SD. Effects of HIV infection and Antiretroviral Therapy on the Heart and Vasculature. Circulation 2008; 118: e36-e40.
23. Petoumenos K, Worm SW. HIV infection, aging and cardiovascular disease: epidemiology and prevention. Sex Health 2011; 8: 465-73.
24. Thailand National Guidelines on HIV/AIDS Treatment and Prevention 2017.แนวทางการตรวจรักษาและป้องกันการติดเชื้อเอชไอวีประเทศไทย ปี 2560. บทนำ.
25. วิชัย เอกพลากร, บรรณาธิการ. รายงานการสำรวจสุขภาพประชาชนไทยโดยการตรวจร่างกายครั้งที่ 5 พ.ศ. 2557. กรุงเทพมหานคร: อักษรกราฟฟิกแอนด์ดีไซน์; 2559. 149-155.
26. ศรีเพ็ญ สวัสดิมงคล, บรรณาธิการ. รายงานประจำปี 2558 สำนักโรคไม่ติดต่อ กรมควบคุมโรค กระทรวงสาธารณสุข. กรุงเทพมหานคร: สำนักงานกิจการโรงพิมพ์องค์การสงเคราะห์ทหารผ่านศึกในพระบรมราชูปถัมภ์; 2559. 11-12.
27. (Abstract) Jantarapakde J, Phanuphak N, Chaturawit C, Pengnonyang S, Mathajittiphan P, Takamtha P, et al. Prevalence of Metabolic Syndrome Among Antiretroviral-Naïve and Antiretroviral-Experienced HIV-1 Infected Thai Adults. AIDS Patient Care STDS 2014; 28(7): 331-40.
28. Santiprabhob J, Tanchaweng S, Maturapat S, Maleesatharn A, Lermankul W, Sricharoenchai S, et al. Metabolic Disorders in HIV-Infected Adolescents
Receiving Protease Inhibitors. BioMed Res Int [serial online] 2017 [cited 2018 March 12]; [14 pages]. Available from: URL: https://www.hindawi.com/ journals/bmri/2017/7481597/
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2019-07-01
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บุญล้อม เ. (2019). Factors associated with primary hypertension in HIV-infected patients on Highly Active Antiretroviral Therapy (HAART) at a District Hospital of Phuket. Region 11 Medical Journal, 33(3), 427–440. Retrieved from https://he02.tci-thaijo.org/index.php/Reg11MedJ/article/view/216413
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