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Abstract：
Hypertension is a significant risk factor for cardiovascular disease, a leading cause of death among people living with HIV (PLWH). Studies suggest that hypertension prevalence among PLWH is high, yet none assess how the 2017 redefinition of hypertension as ≥130/80 rather than the previous standard of ≥140/90 mm Hg will affect prevalence among PLWH. This study addresses this gap.
We examined medical record abstractions of 957 PLWH in Texas from the 2013-2014 Medical Monitoring Project survey. Participants with hypertension were identified by charted diagnosis, antihypertensive medication use, or blood pressure readings ≥140/90 and ≥130/80 mm Hg. Associations with sociodemographic and clinical variables were assessed using Rao-Scott chi-square tests, and odds of having hypertension were calculated using multivariable logistic regression models while adjusting for several demographic and HIV-related variables.
The 2017 redefinition of hypertension increased prevalence in the sample by 44.3%, from 47.6% to 68.7%. Age group, body mass index, sex, and race remained significantly associated with hypertension (all P < 0.01). Although prevalence was near equal between males and females at ≥140/90 mm Hg (47.4% and 48.5%, respectively), males were 2.36 times more likely to have hypertension than females (95% confidence interval [CI]: 1.55-3.60) at ≥130/80 mm Hg. Prevalence remained comparable between white (73.3%) and black participants (72.9%).
This study shows that hypertension prevalence is remarkably high among PLWH and is further increased by updated guidelines. Barriers to hypertension control in the HIV care setting should be identified and addressed to facilitate continued improvement in the quality and length of life for PLWH.
We examined medical record abstractions of 957 PLWH in Texas from the 2013-2014 Medical Monitoring Project survey. Participants with hypertension were identified by charted diagnosis, antihypertensive medication use, or blood pressure readings ≥140/90 and ≥130/80 mm Hg. Associations with sociodemographic and clinical variables were assessed using Rao-Scott chi-square tests, and odds of having hypertension were calculated using multivariable logistic regression models while adjusting for several demographic and HIV-related variables.
The 2017 redefinition of hypertension increased prevalence in the sample by 44.3%, from 47.6% to 68.7%. Age group, body mass index, sex, and race remained significantly associated with hypertension (all P < 0.01). Although prevalence was near equal between males and females at ≥140/90 mm Hg (47.4% and 48.5%, respectively), males were 2.36 times more likely to have hypertension than females (95% confidence interval [CI]: 1.55-3.60) at ≥130/80 mm Hg. Prevalence remained comparable between white (73.3%) and black participants (72.9%).
This study shows that hypertension prevalence is remarkably high among PLWH and is further increased by updated guidelines. Barriers to hypertension control in the HIV care setting should be identified and addressed to facilitate continued improvement in the quality and length of life for PLWH.
摘要：
高血压是心血管疾病的重要危险因素,艾滋病毒感染者（PLWH）的主要死亡原因。研究表明，PLWH中的高血压患病率很高，然而,没有人评估2017年将高血压重新定义为≥130/80,而不是之前的≥140/90mmHg标准将如何影响PLWH的患病率.这项研究解决了这个差距。
我们从2013-2014年医疗监测项目调查中检查了德克萨斯州957PLWH的医疗记录摘要。高血压参与者通过图表诊断进行鉴定，抗高血压药物的使用，或血压读数≥140/90和≥130/80mmHg。使用Rao-Scott卡方检验评估与社会人口统计学和临床变量的关联，和患高血压的几率使用多变量逻辑回归模型计算,同时校正了几个人口统计学和HIV相关变量.
2017年高血压的重新定义使样本中的患病率增加了44.3％，从47.6％到68.7％。年龄组,身体质量指数,性别,种族与高血压有显著相关性(均P<0.01)。尽管男性和女性在≥140/90mmHg时的患病率几乎相等（47.4％和48.5％，分别)，在≥130/80mmHg时,男性患高血压的可能性是女性的2.36倍(95%置信区间[CI]:1.55~3.60).白人（73.3％）和黑人（72.9％）参与者的患病率保持相当。
这项研究表明，高血压患病率在PLWH中非常高，并且随着指南的更新而进一步增加。应确定并解决艾滋病毒护理环境中控制高血压的障碍，以促进PLWH的质量和寿命的持续改善。
我们从2013-2014年医疗监测项目调查中检查了德克萨斯州957PLWH的医疗记录摘要。高血压参与者通过图表诊断进行鉴定，抗高血压药物的使用，或血压读数≥140/90和≥130/80mmHg。使用Rao-Scott卡方检验评估与社会人口统计学和临床变量的关联，和患高血压的几率使用多变量逻辑回归模型计算,同时校正了几个人口统计学和HIV相关变量.
2017年高血压的重新定义使样本中的患病率增加了44.3％，从47.6％到68.7％。年龄组,身体质量指数,性别,种族与高血压有显著相关性(均P<0.01)。尽管男性和女性在≥140/90mmHg时的患病率几乎相等（47.4％和48.5％，分别)，在≥130/80mmHg时,男性患高血压的可能性是女性的2.36倍(95%置信区间[CI]:1.55~3.60).白人（73.3％）和黑人（72.9％）参与者的患病率保持相当。
这项研究表明，高血压患病率在PLWH中非常高，并且随着指南的更新而进一步增加。应确定并解决艾滋病毒护理环境中控制高血压的障碍，以促进PLWH的质量和寿命的持续改善。
