Gender differences in the association of hazardous alcohol use with hypertension in an urban cohort of people living with HIV in South Florida.
TL;DR: Excessive hypertension burden in this population and its association with HAU and sub-optimal care indicate the need for preventive and educational intervention in PLWH.
Abstract: Objective
Industrialized countries are currently experiencing an epidemic of high blood pressure (HBP) extending to people living with HIV (PLWH). Given the prevalence of hazardous alcohol use (HAU), this study examines the relationship between alcohol consumption and hypertension in PLWH. Including a gender analysis is critical, given the high rates of HAU and HIV among females.
Method
We followed PLWH including both HAU and non-HAU (200 each). Participants were assessed twice for body weight, blood pressure, alcohol consumption, and other BP-associated lifestyle factors. High blood pressure (defined as systolic/diastolic blood pressure above 140/90 mmHg and/or treatment of HBP) was the primary outcome.
Results
Overall prevalence of hypertension was 38% and higher among HAU compared to non-HAU (42% vs. 34%, p = 0.02). Less than half with HBP (42%) were receiving treatment for hypertension. Overall, males had a 50% higher risk of HBP than women (odds ratio: 1.5, 95% CI: 1–2.6, p = 0.05). However among HAU, females were twice as likely to suffer HBP as their male counterparts (95% CI: 1–3.9, p = 0.02). Those HAU who preferred liquor, versus wine, had higher adjusted mean BP (132.6±18 vs. 122.3±14 mm Hg, p = 0.05). Additional analyses indicated that consumption of >1 standard drink of liquor or beer/day was associated with HBP. Risk of hypertension was noted in those with daily consumption of >3 glasses of wine. For those reporting <1 drink per day, the odds ratio of having HBP was 0.97 (CI: 0.6–0.99, p = 0.05). Factors associated with hypertension in the multivariate model included increased age, gender, BMI, HAU particularly of liquor, and smoking.
Conclusions
Excessive hypertension burden in this population and its association with HAU and sub-optimal care indicate the need for preventive and educational intervention in PLWH. Analyses highlight the necessity of gender and type-of-beverage specific approaches.
Citations
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TL;DR: The burden of hypertension among people living with HIV is high and its pathophysiology most likely multifactorial, and efforts should be made to improve hypertension management as per existing clinical guidelines in order to safeguard cardiovascular health and quality of life in PLHIV.
Abstract: Purpose of reviewThis review describes what is known concerning the burden of hypertension among people living with HIV (PLHIV), and also addresses relevant topics with respect to its risk factors and clinical management.Recent findingsHypertension is highly prevalent in HIV-positive populations, an
41 citations
Cites result from "Gender differences in the associati..."
...Though many studies – mostly cross-sectional in design – did not confirm the association between cART use and hypertension to be significant [7,9, 11,14,15,25,28,59,80,81,88,114], a recent metaanalysis described that hypertension was more prevalent among antiretroviral therapy-exposed PLHIV compared with antiretroviral therapy-naı̈ve PLHIV [115]....
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Journal Article•
TL;DR: The clinical management of hypertension in HIV-positive patients is similar to those with hypertension in the general population; however, additional considerations should be given to potential drug interactions between antihypertensive agents and antiretroviral drugs to inform the clinician's selection of these therapies.
Abstract: Hypertension among HIV-positive populations has emerged as a new threat to the health and well being of people living with HIV, particularly among those receiving antiretroviral therapy. We reviewed the global evidence on the burden of disease (including prevalence and incidence), determinants of hypertension among HIV-positive populations, and the pharmacological management of hypertension in HIV-positive patients. We systematically searched PubMed-MEDLINE and EMBASE from January 2000 through February 2015 for relevant studies and traced their citations through the ISI Web of Science. We also searched the websites of the World Health Organisation, the International Society of Hypertension, and the International AIDS Society and constructed a narrative data synthesis. Hypertension is common in HIV-positive populations, with prevalence estimates ranging from 4.7 to 54.4% in high-income countries, and from 8.7 to 45.9% in low- and middle-income countries. The role of HIV-specific factors including disease severity, duration of disease, and treatments on the presence of hypertension in HIV-positive patients is reported, but patterns remain unclear. The clinical management of hypertension in HIV-positive patients is similar to those with hypertension in the general population; however, additional considerations should be given to potential drug interactions between antihypertensive agents and antiretroviral drugs to inform the clinician's selection of these therapies. Hypertension is common in HIV-positive populations and remains an important comorbidity affecting mortality outcomes. Further research examining the development of hypertension and its associated care in HIV-positive patients is required to optimize management of the dual conditions.
35 citations
TL;DR: Overall data depict that moderate alcohol intake is also hepatotoxic and decreases intestinal absorption, however, TCE treatment effectively increased the intestinal absorption and retaining power of liver that regulated alcohol-induced multivitamin deficiency.
Abstract: Aims Heavy alcohol intake depletes the plasma vitamins due to hepatotoxicity and decreased intestinal absorption. However, moderate alcohol intake is often thought to be healthy. Therefore, effects of chronic moderate alcohol intake on liver and intestine were studied using urinary vitamin levels. Furthermore, effects of Tinospora cordifolia water extract (TCE) (hepatoprotective) on vitamin excretion and intestinal absorption were also studied.
Methods In the study, asymptomatic moderate alcoholics ( n = 12) without chronic liver disease and healthy volunteers ( n = 14) of mean age 39 ± 2.2 (mean ± SD) were selected and divided into three groups. TCE treatment was performed for 14 days. The blood and urine samples were collected on Day 0 and 14 after treatment with TCE and analyzed.
Results In alcoholics samples, a significant increase in the levels of gamma-glutamyl transferase, aspartate transaminase, alanine transaminase, Triglyceride, Cholesterol, HDL and LDL ( P < 0.05) was observed but their level get downregulated after TCE intervention. Multivariate analysis of metabolites without missing values showed an increased excretion of 7-dehydrocholesterol, orotic acid, pyridoxine, lipoamide and niacin and TCE intervention depleted their levels ( P < 0.05). In contrast, excretion of biotin, xanthine, vitamin D2 and 2- O - p -coumaroyltartronic acid (CA, an internal marker of intestinal absorption) were observed to be decreased in alcoholic samples; however, TCE intervention restored the CA and biotin levels. Vitamin metabolism biomarkers, i.e. homocysteine and xanthurenic acid, were also normalized after TCE intervention.
Conclusion Overall data depict that moderate alcohol intake is also hepatotoxic and decreases intestinal absorption. However, TCE treatment effectively increased the intestinal absorption and retaining power of liver that regulated alcohol-induced multivitamin deficiency.
33 citations
TL;DR: There is no conclusive evidence for spirits being associated with more harm, but some evidence supports for certain outcomes such as injuries and poisonings a potential excess risk for spirits consumption due to rapid ethanol intake and intoxication.
27 citations
TL;DR: Investigating the relationship between HIV viral load and hypertension using viremia copy-years (VCY), a cumulative measure of HIV plasma viral burden, supports the significance of continuous viral suppression in hypertension prevention among PLWH.
Abstract: Background Evidence regarding the association between HIV viral load (VL) and hypertension is inconsistent. In this study, we investigated the relationship using viremia copy-years (VCY), a cumulative measure of HIV plasma viral burden. Methods Data were analyzed for 686 PLWH in the Florida Cohort Study, who had at least five years of VL data before the baseline. VL data were extracted from Enhanced HIV/AIDS Reporting System (eHARS) and used to define peak VL (pVL), recent VL (rVL), and undetectable VL (uVL: rVL 5.7) for analysis. Hypertension was determined based on hypertension diagnosis from medical records. Multivariable logistic regression was used for association analysis. Results Of the total sample, 277 (40.4%) participants were hypertensive. Compared to the participants with lowest VCY (≤2.7 log10 copy × years/mL), the odds ratios (OR) and 95% confidence interval [95% CI] for hypertension of the remaining four groups, in order, were 1.91 [1.11, 3.29], 1.91 [1.03, 3.53], 2.27 [1.29, 3.99], and 1.25 [0.65, 2.42], respectively, controlling for confounders. The association was independent of pVL, rVL, and uVL, each of which was not significantly associated with hypertension. Conclusion Persistent HIV infection is a risk factor for hypertension among PLWH. Information provided by VCY is more effective than single time-point VL measures in investigating HIV infection- hypertension relationship. The findings of this study support the significance of continuous viral suppression in hypertension prevention among PLWH.
7 citations
References
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TL;DR: This work presents a meta-analysis of data from nine studies conducted in Massachusetts over a 10-year period that shows clear trends in mortality and morbidity among veterans aged 65 and over.
Abstract: aDivision of Aging. Department of Medicine. Brigham and Women’s Hospital. Boston. Massachusetts. Estados Unidos. bHarvard Medical School. Boston. Massachusetts. Estados Unidos. cMassachusetts Veterans Epidemiology and Research Information Center (MAVERIC) y Geriatric Research (GRECC). Boston Veterans Affairs Healthcare System. Boston. Massachusetts. Estados Unidos. dDivision of General Medicine and Primary Care. Beth Israel Deaconess Medical Center. Boston. Massachusetts. Estados Unidos. Editorial
16 citations
TL;DR: It is found that frequent consumption of vodka and beer has an adverse impact on health, and it is recommended that policy interventions aimed to address alcohol addiction issues in Russia explicitly differentiate between vodka andBeer drinkers.
Abstract: Introduction and Aims
This study aims to examine the causal effect of alcohol consumption on the risk of high blood pressure in Russia.
Design and Methods
Using data from the Russian Longitudinal Monitoring Survey, we estimated the influence of alcohol consumption on high blood pressure, controlling for social and other factors related to alcohol use. To address the issue of causality, we instrumented alcohol consumption by the number of frequent alcohol drinkers in the household.
Results
We found that frequent consumption of vodka and beer has an adverse impact on health. In particular, frequent vodka consumption increases the likelihood of high blood pressure by 2.88% while frequent beer consumption increases it by 2.06%. Controlling for the endogeneity of frequent alcohol consumption using the instrumental variable method produces an even larger effect for frequent vodka consumption, with a marginal effect of 7.23%.
Discussion and Conclusion
Prevention policies as well as government programs aimed at treating alcohol-related health outcomes should take into consideration the significant adverse effect of alcohol consumption on high blood pressure. It is also recommended that policy interventions aimed to address alcohol addiction issues in Russia explicitly differentiate between vodka and beer drinkers.
14 citations
TL;DR: Tobacco is one of the world’s leading risk factors for premature morbidity and mortality and estimates indicated that tobacco will kill one billion people worldwide in the 21st century.
Abstract: According to the World Health Organization (WHO), tobacco is one of the world’s leading risk factors for premature morbidity and mortality. [1] More people die each year from tobacco related diseases than from HIV, car accidents, alcohol use, illegal drug use, murders, and suicides combined [1]. Worldwide, over two million deaths are attributable to cigarette smoking and estimates indicated that tobacco will kill one billion people worldwide in the 21st century [2].
5 citations
"Gender differences in the associati..." refers background in this paper
...Many of these studies have failed to analyze body composition, although it is known that hypertension commonly clusters with obesity [8]....
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