Oluseye Ayodele Ajayi, Prosper Okonkwo, Temitope Olumuyiwa Ojo, Oluwaseun Kikelomo Ajayi, Olabanjo Ogunsola, Emmanuel Osayi, Ifeyinwa Onwuatuelo, Jay Osi Samuels
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Incident hypertension was based on clinical diagnosis or two consecutive blood pressure readings ⩾140/90 mmHg, taken during the 8 months of data collection. Survival event was defined as incident hypertension during follow-up or interview day for observed patients unless they were right censored. The Kaplan-Meier survival curve was used to estimate the survival probabilities of hypertension. The Cox proportional hazard model was fitted to identify predictors of hypertension at <i>p</i> < 0.05.</p><p><strong>Results: </strong>A total of 2503 PLHIV was followed up. The majority were females (74.6%) and on Dolutegravir-based therapy (93.0%). About 22 (0.9%) were diabetic. Median age at ART initiation was 35 (interquartile range: 29-41) years. The median period of follow-up was 12.0 ± 3.9 years. The cumulative incidence of hypertension was 32.5% (381/2540), with an incidence rate of 40.1/1000 person-years. The median time to incident hypertension was 17.0 years (95% CI: 12.5-21.5 years). Shorter hypertension-free survival times were seen in males, those aged 60+, with diabetes, unsuppressed viral load, history of tuberculosis, other opportunistic infections, or co-trimoxazole use. Significant risk factors included male sex (adjusted odds ratio (AOR) = 1.3, 95% CI = 1.1-1.6), middle age (AOR = 2.3, 95% CI = 1.7-3.2), old age (AOR = 5.6, 95% CI = 3.9-8.4), and unsuppressed viral load (AOR = 1.9, 95% CI = 1.3-2.7).</p><p><strong>Conclusion: </strong>Hypertension is commoner among PLHIV with unsuppressed viral load, males, and persons older than 40 years. Effective ART with viral suppression remains essential. Incorporating regular hypertension screening and treatment into HIV care is necessary for optimum health outcomes.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241289800"},"PeriodicalIF":3.8000,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11489917/pdf/","citationCount":"0","resultStr":"{\"title\":\"Time to incident hypertension and independent predictors among people living with HIV in Nigeria.\",\"authors\":\"Oluseye Ayodele Ajayi, Prosper Okonkwo, Temitope Olumuyiwa Ojo, Oluwaseun Kikelomo Ajayi, Olabanjo Ogunsola, Emmanuel Osayi, Ifeyinwa Onwuatuelo, Jay Osi Samuels\",\"doi\":\"10.1177/20499361241289800\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Understanding the time to hypertension occurrence after antiretroviral treatment (ART) initiation in people living with HIV (PLHIV) and its determinants is important for designing interventions for control.</p><p><strong>Objective: </strong>This study sought to estimate the median time of ART use to hypertension onset and its predictors in Nigerian PLHIV.</p><p><strong>Design: </strong>A retrospective longitudinal study.</p><p><strong>Methods: </strong>This retrospective review of 2503 normotensive adult PLHIV (⩾18 years) from 2004 to 2020 in two HIV clinics in Nigeria. Incident hypertension was based on clinical diagnosis or two consecutive blood pressure readings ⩾140/90 mmHg, taken during the 8 months of data collection. Survival event was defined as incident hypertension during follow-up or interview day for observed patients unless they were right censored. The Kaplan-Meier survival curve was used to estimate the survival probabilities of hypertension. The Cox proportional hazard model was fitted to identify predictors of hypertension at <i>p</i> < 0.05.</p><p><strong>Results: </strong>A total of 2503 PLHIV was followed up. The majority were females (74.6%) and on Dolutegravir-based therapy (93.0%). About 22 (0.9%) were diabetic. Median age at ART initiation was 35 (interquartile range: 29-41) years. The median period of follow-up was 12.0 ± 3.9 years. The cumulative incidence of hypertension was 32.5% (381/2540), with an incidence rate of 40.1/1000 person-years. The median time to incident hypertension was 17.0 years (95% CI: 12.5-21.5 years). Shorter hypertension-free survival times were seen in males, those aged 60+, with diabetes, unsuppressed viral load, history of tuberculosis, other opportunistic infections, or co-trimoxazole use. Significant risk factors included male sex (adjusted odds ratio (AOR) = 1.3, 95% CI = 1.1-1.6), middle age (AOR = 2.3, 95% CI = 1.7-3.2), old age (AOR = 5.6, 95% CI = 3.9-8.4), and unsuppressed viral load (AOR = 1.9, 95% CI = 1.3-2.7).</p><p><strong>Conclusion: </strong>Hypertension is commoner among PLHIV with unsuppressed viral load, males, and persons older than 40 years. Effective ART with viral suppression remains essential. 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引用次数: 0
摘要
背景：了解艾滋病病毒感染者（PLHIV）开始接受抗逆转录病毒治疗（ART）后出现高血压的时间及其决定因素，对于设计控制干预措施非常重要：本研究旨在估算尼日利亚艾滋病病毒感染者从接受抗逆转录病毒疗法到高血压发病的中位时间及其预测因素：设计：回顾性纵向研究：本研究对尼日利亚两家 HIV 诊所 2004 年至 2020 年期间 2503 名血压正常的成年 PLHIV（18 岁以下）进行了回顾性研究。事件性高血压基于临床诊断或在数据收集的 8 个月内连续两次血压读数⩾140/90 mmHg。生存事件的定义是，在随访期间或访谈日观察到的患者出现高血压，除非他们是右剔除的。Kaplan-Meier 生存曲线用于估算高血压的生存概率。结果：共有 2503 名艾滋病毒感染者接受了随访。其中大多数为女性（74.6%），并且正在接受基于多特拉韦的治疗（93.0%）。约 22 人（0.9%）患有糖尿病。开始接受抗逆转录病毒疗法时的中位年龄为 35 岁（四分位数间距：29-41）。随访时间的中位数为 12.0 ± 3.9 年。高血压累计发病率为 32.5%（381/2540），发病率为 40.1/1000 人年。发生高血压的中位时间为 17.0 年（95% CI：12.5-21.5 年）。男性、60 岁以上者、糖尿病患者、未抑制的病毒载量、结核病史、其他机会性感染或使用联合三唑类药物者的无高血压存活时间较短。重要的风险因素包括男性（调整后的几率比（AOR）=1.3，95% CI =1.1-1.6）、中年（AOR =2.3，95% CI =1.7-3.2）、老年（AOR =5.6，95% CI =3.9-8.4）和未抑制的病毒载量（AOR =1.9，95% CI =1.3-2.7）：高血压在病毒载量未得到抑制的艾滋病毒感染者、男性和 40 岁以上的人群中更为常见。有效抑制病毒载量的抗逆转录病毒疗法仍然至关重要。将定期的高血压筛查和治疗纳入艾滋病护理中对于获得最佳的健康结果是必要的。
Time to incident hypertension and independent predictors among people living with HIV in Nigeria.
Background: Understanding the time to hypertension occurrence after antiretroviral treatment (ART) initiation in people living with HIV (PLHIV) and its determinants is important for designing interventions for control.
Objective: This study sought to estimate the median time of ART use to hypertension onset and its predictors in Nigerian PLHIV.
Design: A retrospective longitudinal study.
Methods: This retrospective review of 2503 normotensive adult PLHIV (⩾18 years) from 2004 to 2020 in two HIV clinics in Nigeria. Incident hypertension was based on clinical diagnosis or two consecutive blood pressure readings ⩾140/90 mmHg, taken during the 8 months of data collection. Survival event was defined as incident hypertension during follow-up or interview day for observed patients unless they were right censored. The Kaplan-Meier survival curve was used to estimate the survival probabilities of hypertension. The Cox proportional hazard model was fitted to identify predictors of hypertension at p < 0.05.
Results: A total of 2503 PLHIV was followed up. The majority were females (74.6%) and on Dolutegravir-based therapy (93.0%). About 22 (0.9%) were diabetic. Median age at ART initiation was 35 (interquartile range: 29-41) years. The median period of follow-up was 12.0 ± 3.9 years. The cumulative incidence of hypertension was 32.5% (381/2540), with an incidence rate of 40.1/1000 person-years. The median time to incident hypertension was 17.0 years (95% CI: 12.5-21.5 years). Shorter hypertension-free survival times were seen in males, those aged 60+, with diabetes, unsuppressed viral load, history of tuberculosis, other opportunistic infections, or co-trimoxazole use. Significant risk factors included male sex (adjusted odds ratio (AOR) = 1.3, 95% CI = 1.1-1.6), middle age (AOR = 2.3, 95% CI = 1.7-3.2), old age (AOR = 5.6, 95% CI = 3.9-8.4), and unsuppressed viral load (AOR = 1.9, 95% CI = 1.3-2.7).
Conclusion: Hypertension is commoner among PLHIV with unsuppressed viral load, males, and persons older than 40 years. Effective ART with viral suppression remains essential. Incorporating regular hypertension screening and treatment into HIV care is necessary for optimum health outcomes.
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