Abstract
There are increasing researches about non-communicable disease such as elevated blood pressure among people living with HIV before and after initiation of highly active antiretroviral therapy (HAART). This cross-sectional study was designed to determine the prevalence of hypertension and associated risk factors among 340 HIV-infected patients on antiretroviral therapy at a Malaysian public hospital providing HIV-related treatment. Data on socioeconomic background, anthropometry, medical history and dietary intake of the patients were collected. Hypertension is defined as blood pressure ≥130/85 (mm Hg). Prevalence of hypertension was 45.60% (n=155) of which 86.5% of the hypertensive group were male (n=134). The results showed that increase in age (OR 1.051, 95% confidence interval (CI) 1.024-1.078), higher body mass index (OR 1.18, 95% CI 1.106-2.71), bigger waist circumference (OR 1.18, 95%CI 1.106-2.71), higher waist-hip ratio (OR 1.070, 95%CI 1.034-1.106), higher fasting plasma glucose (OR 1.332, 95% CI 0.845-2.100) and percentage energy intake from protein >15 (OR 2.519, 95%CI 1.391-4.561) were significant risk factors for hypertension (p<0.001). After adjusting for other variables, increasing age (adjusted odds ratio (aOR) 1.069 95%CI 1.016-1.124, p=0.010), being male (aOR 3.026, 95%CI 1.175-7.794, p=0.022) and higher body mass index (aOR 1.26, 95%CI 1.032-1.551, p=0.024) were independently associated with hypertension. None of the antiretroviral therapy and immunologic factors was linked to hypertension. In conclusion hypertension among PLHIV was linked to the well-known risk factors such as age, gender and body mass index. With HAART, people can live longer by making monitoring and control of some reversible factors, especially excessive weight gain for maintaining quality of life.
Highlights
There has been some evidence of an increased risk of hypertension among people living with HIV/AIDS (PLHIV) (Medina-Torne, Ganesan, Barahona, & Crum-Cianflone, 2012; Nüesch et al, 2013)
The results showed that increase in age (OR 1.051, 95% confidence interval (CI) 1.024-1.078), higher body mass index, bigger waist circumference, higher waist-hip ratio, higher fasting plasma glucose and percentage energy intake from protein >15 were significant risk factors for hypertension (p
One possible reason is due to the difference in cut-off points for definition of hypertension between the present study which used the NCEP guidelines which considered a lower cut-off point level (BP>130/85 mm Hg) than NHMS Survey (MOH Malaysia, 2012b) which defined hypertension as BP>140/90 mm Hg
Summary
There has been some evidence of an increased risk of hypertension among PLHIV (Medina-Torne, Ganesan, Barahona, & Crum-Cianflone, 2012; Nüesch et al, 2013). Lipodystrophy syndrome including fat maldistribution with dyslipidemia, insulin resistance and metabolic complications (Tsiodras, Mantzoros, Hammer, & Samore, 2000; Kerr et al, 2007; Hejazi, Rajikan, Choong & Sahar, 2013; Zha et al, 2013), obesity/central adiposity (Hejazi, Lee, Lin, & Choong, 2010), metabolic syndrome and diabetes mellitus (Diouf et al, 2012; Gupt et al, 2012) hypertension (Baekken, Sandvik, & Oektedalen, 2008; Diouf et al, 2012; Mateen et al, 2013) and cardiovascular diseases (Mary-Krause, Cotte, Simon, Partisani, & Costagliola, 2003; Friis-Moller et al, 2007) are some of the common side-effects of treatment with the protease inhibitors (PIs) as the third class of antiretroviral (ARV) medications These non-communicable chronic diseases (NCCDs) with their heightened incidence have significant undesirable impact on treatment of PLHIV and their quality of life (Shenoy et al, 2013). At the same time with the HIV’s aging population, NCCDs are a growing problem among this population (Rabkin, Kruk, & El-Sadr, 2012)
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