Racial disparities in the prevalence and control of hypertension among a cohort of HIV-infected patients in the southeastern United States.

Autor: Burkholder GA; Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, United States of America., Tamhane AR; Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.; Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, United States of America., Safford MM; Division of General Internal Medicine, Weill Cornell Medical College, New York City, New York, United States of America., Muntner PM; Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America., Willig AL; Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, United States of America., Willig JH; Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, United States of America., Raper JL; Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, United States of America., Saag MS; Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, United States of America., Mugavero MJ; Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2018 Mar 29; Vol. 13 (3), pp. e0194940. Date of Electronic Publication: 2018 Mar 29 (Print Publication: 2018).
DOI: 10.1371/journal.pone.0194940
Abstrakt: Background: African Americans are disproportionately affected by both HIV and hypertension. Failure to modify risk factors for cardiovascular disease and chronic kidney disease such as hypertension among HIV-infected patients may attenuate the benefits conferred by combination antiretroviral therapy. In the general population, African Americans with hypertension are less likely to have controlled blood pressure than whites. However, racial differences in blood pressure control among HIV-infected patients are not well studied.
Methods: We conducted a cross-sectional study evaluating racial differences in hypertension prevalence, treatment, and control among 1,664 patients attending the University of Alabama at Birmingham HIV Clinic in 2013. Multivariable analyses were performed to calculate prevalence ratios (PR) with 95% confidence intervals (CI) as the measure of association between race and hypertension prevalence and control while adjusting for other covariates.
Results: The mean age of patients was 47 years, 77% were male and 54% African-American. The prevalence of hypertension was higher among African Americans compared with whites (49% vs. 43%; p = 0.02). Among those with hypertension, 91% of African Americans and 93% of whites were treated (p = 0.43). Among those treated, 50% of African Americans versus 60% of whites had controlled blood pressure (systolic blood pressure <140 mmHg and diastolic blood pressure <90 mmHg) (p = 0.007). After multivariable adjustment for potential confounders, prevalence of hypertension was higher among African Americans compared to whites (PR 1.25; 95% CI 1.12-1.39) and prevalence of BP control was lower (PR 0.80; 95% CI 0.69-0.93).
Conclusions: Despite comparable levels of hypertension treatment, African Americans in our HIV cohort were less likely to achieve blood pressure control. This may place them at increased risk for adverse outcomes that disproportionately impact HIV-infected patients, such as cardiovascular disease and chronic kidney disease, and thus attenuate the benefits conferred by combination antiretroviral therapy.
Databáze: MEDLINE
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