Prevalence, Awareness, Treatment, and Control Rate of Hypertension in HIV-Infected Patients: The HIV-HY Study
Prevalence, Awareness, Treatment, and Control Rate of Hypertension in HIV-Infected Patients: The HIV-HY Study
复制标题
DOI：
10.1093/ajh/hpt182
复制
发表时间：
2014-02-01
影响因子：
3.2
通讯作者：
Schillaci, Giuseppe
中科院分区：
文献类型：
--
作者：
De Socio, Giuseppe Vittorio;Ricci, Elena;Schillaci, Giuseppe
我们的目的是评估高血压的患病率在一个人免疫缺陷病毒（HIV）感染的人群，并确定与高血压患病率，治疗和控制的相关因素。我们使用了一个多中心，横断面，全国范围内的研究，抽样1,182个连续的，HIV感染的患者。门诊血压测量采用标准程序，患者71%为男性，92%为白色，中位年龄为47岁（范围1878），6%为抗逆转录病毒治疗初治。高血压的总患病率为29.3%，正常高血压占12.3%。在高血压患者中，64.9%的人知道自己的高血压状况，52.9%的人接受了治疗，33.0%的人得到了控制（血压< 140/90 mm Hg）。54.3%的受试者在单药治疗中使用降压药物。血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂是最常用的药物（76.1%）：单药治疗39.1%，联合治疗37.0%。在多变量回归模型中，高血压是由传统危险因素独立预测的，包括年龄50岁、男性、心血管疾病家族史、体重指数25 kg/m2、既往心血管事件、糖尿病、向心性肥胖和代谢综合征，以及HIV感染持续时间、抗逆转录病毒治疗持续时间和最低CD 4 T细胞计数< 200/l。蛋白酶抑制剂与非核苷类逆转录酶抑制剂作为第三种抗逆转录病毒药物的选择无关。高血压影响意大利近30%的HIV成人门诊患者。超过三分之一的高血压患者不知道自己的病情，超过三分之二的高血压患者病情未得到控制。在这种情况下，必须高度重视高血压的诊断和治疗。
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.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.Patients were 71% men and 92% white, with a median age of 47 years (range 1878); 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 pressurelowering 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/m(2), 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/l. The choice of protease inhibitors vs. nonnucleoside reverse transcriptase inhibitors as a third antiretroviral drug was irrelevant.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.