Hypertension, kidney disease, HIV and antiretroviral therapy among Tanzanian adults: a cross-sectional study.
Robert N. Peck,Robert N. Peck,Rehema Shedafa,Samuel E. Kalluvya,Jennifer A. Downs,Jennifer A. Downs,Jim Todd,Manikkam Suthanthiran,Daniel W. Fitzgerald,Johannes B. Kataraihya +9 more
Reads0
Chats0
TLDR
HIV-infected adults on ART >2 years had two-fold greater odds of hypertension than HIV-negative controls, and intensive hypertension screening and education are needed in HIV-clinics in sub-Saharan Africa.Abstract:
The epidemics of HIV and hypertension are converging in sub-Saharan Africa. Due to antiretroviral therapy (ART), more HIV-infected adults are living longer and gaining weight, putting them at greater risk for hypertension and kidney disease. The relationship between hypertension, kidney disease and long-term ART among African adults, though, remains poorly defined. Therefore, we determined the prevalences of hypertension and kidney disease in HIV-infected adults (ART-naive and on ART >2 years) compared to HIV-negative adults. We hypothesized that there would be a higher hypertension prevalence among HIV-infected adults on ART, even after adjusting for age and adiposity. In this cross-sectional study conducted between October 2012 and April 2013, consecutive adults (>18 years old) attending an HIV clinic in Tanzania were enrolled in three groups: 1) HIV-negative controls, 2) HIV-infected, ART-naive, and 3) HIV-infected on ART for >2 years. The main study outcomes were hypertension and kidney disease (both defined by international guidelines). We compared hypertension prevalence between each HIV group versus the control group by Fisher’s exact test. Logistic regression was used to determine if differences in hypertension prevalence were fully explained by confounding. Among HIV-negative adults, 25/153 (16.3%) had hypertension (similar to recent community survey data). HIV-infected adults on ART had a higher prevalence of hypertension (43/150 (28.7%), P = 0.01) and a higher odds of hypertension even after adjustment (odds ratio (OR) = 2.19 (1.18 to 4.05), P = 0.01 in the best model). HIV-infected, ART-naive adults had a lower prevalence of hypertension (8/151 (5.3%), P = 0.003) and a lower odds of hypertension after adjustment (OR = 0.35 (0.15 to 0.84), P = 0.02 in the best model). Awareness of hypertension was ≤25% among hypertensive adults in all three groups. Kidney disease was common in all three groups (25.6% to 41.3%) and strongly associated with hypertension (P 2 years had two-fold greater odds of hypertension than HIV-negative controls. HIV-infected adults with hypertension were rarely aware of their diagnosis but often have evidence of kidney disease. Intensive hypertension screening and education are needed in HIV-clinics in sub-Saharan Africa. Further studies should determine if chronic, dysregulated inflammation may accelerate hypertension in this population.read more
Citations
More filters
Journal ArticleDOI
Characteristics, Prevention, and Management of Cardiovascular Disease in People Living With HIV: A Scientific Statement From the American Heart Association.
Matthew J. Feinstein,Priscilla Y. Hsue,Laura A Benjamin,Gerald S. Bloomfield,Judith S. Currier,Matthew S. Freiberg,Steven K. Grinspoon,Jules Levin,Chris T. Longenecker,Wendy S. Post +9 more
TL;DR: A thorough review of the existing evidence on HIV-associated CVD, in particular atherosclerotic CVD (including myocardial infarction and stroke) and heart failure, as well as pragmatic recommendations on how to approach CVD prevention and treatment in HIV in the absence of large-scale randomized controlled trial data are provided.
Journal ArticleDOI
Global prevalence of hypertension among people living with HIV: a systematic review and meta-analysis
Yunan Xu,Xinguang Chen,Kai Wang +2 more
TL;DR: The estimated prevalence of hypertension among people living with HIV shows an increasing trend and is associated with receiving ART and older age and was found increased with age and in studies conducted after 2010.
Journal ArticleDOI
Hypertension in HIV-Infected Adults: Novel Pathophysiologic Mechanisms.
TL;DR: The mechanisms of hypertension in HIV infection are explored, which are critical to public health efforts to prevent hypertension, cardiovascular disease and premature mortality in HIV-infected adults.
Journal ArticleDOI
Evidence of increased blood pressure and hypertension risk among people living with HIV on antiretroviral therapy: a systematic review with meta-analysis
Chidozie U. Nduka,Saverio Stranges,Ahmed M. Sarki,Peter K. Kimani,Olalekan A. Uthman,Olalekan A. Uthman +5 more
TL;DR: Exposure to ART is significantly associated with increased systolic and diastolic blood pressure levels, and increased risk of hypertension, regardless of study-level sociodemographic differences, which supports the need for population-based strategies to reduce the risk of high blood pressure among people living with HIV on ART.
Journal ArticleDOI
Chronic kidney disease in the global adult HIV-infected population: A systematic review and meta-analysis.
Udeme E. Ekrikpo,Andre Pascal Kengne,Aminu K. Bello,Emmanuel E Effa,Jean Jacques Noubiap,Babatunde L. Salako,Brian Rayner,Giuseppe Remuzzi,Ikechi G. Okpechi +8 more
TL;DR: CKD is common in HIV-infected people, particularly in Africa, and HIV treatment programs need to intensify screening for CKD with added need to introduce global guidelines for CKd identification and treatment in HIV positive patients.
References
More filters
Journal ArticleDOI
The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report.
Aram V. Chobanian,George L. Bakris,Henry R. Black,William C. Cushman,Lee A. Green,Joseph L. Izzo,Daniel W. Jones,Barry J. Materson,Suzanne Oparil,Jackson T. Wright,Edward J. Roccella +10 more
TL;DR: The most effective therapy prescribed by the most careful clinician will control hypertension only if patients are motivated, and empathy builds trust and is a potent motivator.
Journal ArticleDOI
Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
Aram V. Chobanian,George L. Bakris,Henry R. Black,William C. Cushman,Lee A. Green,Joseph L. Izzo,Daniel W. Jones,Barry J. Materson,Suzanne Oparil,Jackson T. Wright,Edward J. Roccella +10 more
TL;DR: In those older than age 50, systolic blood pressure of greater than 140 mm Hg is a more important cardiovascular disease (CVD) risk factor than diastolic BP, and hypertension will be controlled only if patients are motivated to stay on their treatment plan.
Journal ArticleDOI
A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010
Stephen S Lim,Theo Vos,Abraham D. Flaxman,Goodarz Danaei,Kenji Shibuya,Heather Adair-Rohani,Mohammad A. AlMazroa,Markus Amann,H. Ross Anderson,Kathryn G. Andrews,Martin J. Aryee,Charles Atkinson,Loraine J. Bacchus,Adil N. Bahalim,Kalpana Balakrishnan,John R. Balmes,Suzanne Barker-Collo,Amanda J Baxter,Michelle L. Bell,Jed D. Blore,Fiona M. Blyth,Carissa Bonner,Guilherme Borges,Rupert R A Bourne,Michel Boussinesq,Michael Brauer,Peter Brooks,Nigel Bruce,Bert Brunekreef,Claire Bryan-Hancock,Chiara Bucello,Rachelle Buchbinder,Fiona Bull,Richard T. Burnett,Tim Byers,Bianca Calabria,Jonathan R. Carapetis,Emily Carnahan,Zoë Chafe,Fiona J Charlson,Honglei Chen,Jian Shen Chen,Andrew T. A. Cheng,Jennifer C. Child,Aaron Cohen,K. Ellicott Colson,Benjamin C Cowie,Sarah C. Darby,Susan Darling,Adrian Davis,Louisa Degenhardt,Frank Dentener,Don C. Des Jarlais,Karen Devries,Mukesh Dherani,Eric L. Ding,E. Ray Dorsey,Tim Driscoll,Karen Edmond,S. Ali,Rebecca E. Engell,Patricia J. Erwin,Saman Fahimi,Gail Falder,Farshad Farzadfar,Alize J. Ferrari,Mariel M. Finucane,Seth Flaxman,F.G.R. Fowkes,Greg Freedman,Michael Freeman,Emmanuela Gakidou,Santu Ghosh,Edward Giovannucci,Gerhard Gmel,Kathryn Graham,Rebecca Grainger,Rebecca Grainger,Bridget F. Grant,David Gunnell,Hialy R. Gutierrez,Wayne Hall,Hans W. Hoek,Anthony Hogan,H. Dean Hosgood,Damian G Hoy,Howard Hu,Bryan Hubbell,Sally Hutchings,Sydney E. Ibeanusi,Gemma Jacklyn,Rashmi Jasrasaria,Jost B. Jonas,Haidong Kan,John A. Kanis,Nicholas J Kassebaum,Norito Kawakami,Young-Ho Khang,Shahab Khatibzadeh,Jon-Paul Khoo,Cindy Kok,Francine Laden,Ratilal Lalloo,Qing Lan,Tim Lathlean,Janet L Leasher,James Leigh,Yang Li,John K Lin,Steven E. Lipshultz,Stephanie J. London,Rafael Lozano,Yuan Lu,Joelle Mak,Reza Malekzadeh,Leslie Mallinger,Wagner Marcenes,Lyn March,Robin Marks,Randall V. Martin,Paul McGale,John J. McGrath,Sumi Mehta,Ziad A. Memish,George A. Mensah,Tony R. Merriman,Renata Micha,Renata Micha,Catherine Michaud,Vinod Mishra,Khayriyyah Mohd Hanafiah,Ali A. Mokdad,Lidia Morawska,Dariush Mozaffarian,Tasha B. Murphy,Mohsen Naghavi,Bruce Neal,Paul K. Nelson,Joan M. Nolla,Rosana E. Norman,Casey Olives,Saad B. Omer,Jessica Orchard,Richard H. Osborne,Bart Ostro,Andrew Page,Kiran Pandey,Charles D. H. Parry,Erin Passmore,Jayadeep Patra,Neil Pearce,Pamela M. Pelizzari,Max Petzold,Michael Phillips,Daniel Pope,C. Arden Pope,John Powles,Mayuree Rao,Homie Razavi,Eva Rehfuess,Jürgen Rehm,Beate Ritz,Frederick P. Rivara,Thomas Roberts,Carolyn Robinson,Jose Adolfo Rodriguez-Portales,Isabelle Romieu,Robin Room,Lisa C. Rosenfeld,Ananya Roy,Lesley Rushton,Joshua A. Salomon,Uchechukwu Sampson,Lidia Sanchez-Riera,Ella Sanman,Amir Sapkota,Soraya Seedat,Peilin Shi,Kevin D. Shield,Rupak Shivakoti,Gitanjali M Singh,David A. Sleet,Emma Smith,Kirk R. Smith,Nicolas J. C. Stapelberg,Kyle Steenland,Heidi Stöckl,Lars Jacob Stovner,Kurt Straif,Lahn Straney,George D. Thurston,Jimmy H. Tran,Rita Van Dingenen,Aaron van Donkelaar,J. Lennert Veerman,Lakshmi Vijayakumar,Robert G. Weintraub,Myrna M. Weissman,Richard A. White,Harvey Whiteford,Steven T. Wiersma,James D. Wilkinson,Hywel C Williams,Warwick Williams,Nick Wilson,Anthony D. Woolf,Paul S. F. Yip,Jan M Zielinski,Alan D. Lopez,Christopher J L Murray,Majid Ezzati +210 more
TL;DR: In this paper, the authors estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010.
Journal ArticleDOI
Kidney disease: improving global outcomes (KDIGO) CKD work group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease
Adeera Levin,Paul E. Stevens,Rudy Bilous,Josef Coresh,Alm deFrancisco,Pe Dejong,K.E. Griffith,Brenda R. Hemmelgarn,Kunitoshi Iseki,EJ Lamb,Andrew S. Levey,Miguel C. Riella,Michael G. Shlipak,Hongya Wang,Colin T. White,Christopher G. Winearls +15 more
Journal ArticleDOI
Mortality in the highly active antiretroviral therapy era: changing causes of death and disease in the HIV outpatient study.
Frank J. Palella,Rose K. Baker,Anne C. Moorman,Joan S. Chmiel,Kathleen C. Wood,John T. Brooks,Scott D. Holmberg +6 more
TL;DR: Although overall death rates remained low through 2004, the proportion of deaths attributable to non- AIDS diseases increased and prominently included hepatic, cardiovascular, and pulmonary diseases, as well as non-AIDS malignancies.
Related Papers (5)
Global prevalence of hypertension among people living with HIV: a systematic review and meta-analysis
Yunan Xu,Xinguang Chen,Kai Wang +2 more