De Socio, Giuseppe Vittorio Luigi and Ricci, Elena and Maggi, Paolo and Parruti, Giustino and Pucci, Giacomo and Di Biagio, Antonio and Calza, Leonardo and Orofino, Giancarlo and Carenzi, Laura and Cecchini, Enisia and Madeddu, Giordano and Quirino, Tiziana and Schillaci, Giuseppe (2014) Prevalence, awareness, treatment, and control rate of hypertension in HIV-infected patients: the HIV-HY study. American Journal of Hypertension, Vol. 27 (2), p. 222-228. ISSN 0895-7061. eISSN 1941-7225. Article.
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Background: We aimed to assess the prevalence of hypertension in an unselected human immunodeficiency virus (HIV)–infected population and to identify factors associated with hypertension prevalence, treatment, and control.
Methods: We used a multicenter, cross-sectional, nationwide study that sampled 1,182 unselected, consecutive, HIV-infected patients. Office blood pressure was accurately measured with standard procedures.
Results: Patients were 71% men and 92% white, with a median age of 47 years (range = 18–78); 6% were antiretroviral treatment naive. The overall prevalence of hypertension was 29.3%; high-normal pressure accounted for an additional 12.3%. Among hypertensive subjects, 64.9% were aware of their hypertensive condition, 52.9% were treated, and 33.0% were controlled (blood pressure < 140/90mm Hg). Blood pressure–lowering medications were used in monotherapy in 54.3% of the subjects. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers were the most frequently used drugs (76.1%: monotherapy = 39.1%, combination treatment = 37.0%). In multivariable regression models, hypertension was independently predicted by traditional risk factors, including age ≥50 years, male sex, family history of cardiovascular disease, body mass index ≥25kg/m2, previous cardiovascular events, diabetes, central obesity, and metabolic syndrome, as well as by duration of HIV infection, duration of antiretroviral therapy, and nadir CD4+ T-cell count <200/µl. The choice of protease inhibitors vs. nonnucleoside reverse transcriptase inhibitors as a third antiretroviral drug was irrelevant.
Conclusions: Hypertension affects nearly 30% of HIV adult outpatients in Italy. More than one-third of the hypertensive subjects are unaware of their condition, and more than two-thirds are uncontrolled. A higher level of attention to the diagnosis and treatment of hypertension is mandatory in this setting.
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