D-dimer levels and traditional risk factors are associated with incident hypertension among HIV-infected individuals initiating antiretroviral therapy in Uganda
OBJECTIVES:We sought to describe blood pressure changes after antiretroviral therapy (ART) initiation and evaluate the association of markers of inflammation with incident hypertension in a cohort of HIV-individuals in Uganda. METHODS:We used mixed effects linear regression to model changes in systo...
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| Veröffentlicht in: | Journal of acquired immune deficiency syndromes (1999) 2016-12, Vol.73 (4), p.396-402 |
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| creator | Okello, Samson Asiimwe, Stephen B Kanyesigye, Michael Muyindike, Winnie R Boum, Yap Mwebesa, Bosco Bwana Haberer, Jessica E Huang, Yong Williams, Kenneth Burdo, Tricia H Tracy, Russell P Bangsberg, David R Mocello, A Rain Martin, Jeffrey N Hunt, Peter W Siedner, Mark J |
| description | OBJECTIVES:We sought to describe blood pressure changes after antiretroviral therapy (ART) initiation and evaluate the association of markers of inflammation with incident hypertension in a cohort of HIV-individuals in Uganda.
METHODS:We used mixed effects linear regression to model changes in systolic blood pressure (BP) over time among a cohort of HIV-infected individuals initiating ART in Uganda. After exclusion of participants with pre-existing hypertension, we identified participants with normal BP throughout follow-up (controls) and those with elevated BP on ≥3 consecutive visits (cases). Prior to ART initiation, participants had testing for lnterleukin-6, kynurenine/tryptophan ratio, lipopolysaccharide, soluble CD14, soluble CD163, and D-dimer and those with viral suppression at six months during ART had repeat tests. We fit logistic regression models to estimate associations between biomarkers and risk of incident hypertension.
RESULTS:In the entire cohort, systolic BP increased by 9.6 mmHg/year (95% CI 7.3 - 11.8) in the first six months of ART, then plateaued. Traditional factorsmale gender (AOR 2.76, 95% CI 1.34-5.68), age (AOR 1.09, 95% CI 1.04-1.13), overweight (AOR 4.48, 95%CI 1.83-10.97), and a CD4 count < 100 cells (AOR 3.08, 95% CI 1.07-8.89) were associated with incident hypertension. After adjusting for these, D-dimer levels at month 6 were inversely associated with incident hypertension (AOR 0.61, 95% CI 0.37-0.99). Although not significant, similar associations were seen with sCD14 and Kynurenine/Tryptophan (K/T) ratio.
CONCLUSION:Blood pressure increases early after ART initiation in Ugandans. Traditional risk factors, rather than immune activation were associated with incident hypertension in this population. |
| doi_str_mv | 10.1097/QAI.0000000000001074 |
| format | Article |
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METHODS:We used mixed effects linear regression to model changes in systolic blood pressure (BP) over time among a cohort of HIV-infected individuals initiating ART in Uganda. After exclusion of participants with pre-existing hypertension, we identified participants with normal BP throughout follow-up (controls) and those with elevated BP on ≥3 consecutive visits (cases). Prior to ART initiation, participants had testing for lnterleukin-6, kynurenine/tryptophan ratio, lipopolysaccharide, soluble CD14, soluble CD163, and D-dimer and those with viral suppression at six months during ART had repeat tests. We fit logistic regression models to estimate associations between biomarkers and risk of incident hypertension.
RESULTS:In the entire cohort, systolic BP increased by 9.6 mmHg/year (95% CI 7.3 - 11.8) in the first six months of ART, then plateaued. Traditional factorsmale gender (AOR 2.76, 95% CI 1.34-5.68), age (AOR 1.09, 95% CI 1.04-1.13), overweight (AOR 4.48, 95%CI 1.83-10.97), and a CD4 count < 100 cells (AOR 3.08, 95% CI 1.07-8.89) were associated with incident hypertension. After adjusting for these, D-dimer levels at month 6 were inversely associated with incident hypertension (AOR 0.61, 95% CI 0.37-0.99). Although not significant, similar associations were seen with sCD14 and Kynurenine/Tryptophan (K/T) ratio.
CONCLUSION:Blood pressure increases early after ART initiation in Ugandans. Traditional risk factors, rather than immune activation were associated with incident hypertension in this population.</description><identifier>ISSN: 1525-4135</identifier><identifier>EISSN: 1944-7884</identifier><identifier>DOI: 10.1097/QAI.0000000000001074</identifier><identifier>PMID: 27171743</identifier><identifier>CODEN: JDSRET</identifier><language>eng</language><publisher>United States: Copyright Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Adult ; AIDS/HIV ; Anti-HIV Agents - therapeutic use ; Antihypertensive Agents - administration & dosage ; Antihypertensive Agents - therapeutic use ; Antiretroviral drugs ; Biomarkers ; Cytokines ; Female ; Fibrin Fibrinogen Degradation Products - metabolism ; HIV ; HIV Infections - complications ; HIV Infections - drug therapy ; Human immunodeficiency virus ; Humans ; Hypertension ; Hypertension - drug therapy ; Hypertension - etiology ; Lentivirus ; Male ; Regression analysis ; Retroviridae ; Risk Factors</subject><ispartof>Journal of acquired immune deficiency syndromes (1999), 2016-12, Vol.73 (4), p.396-402</ispartof><rights>Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>Copyright Lippincott Williams & Wilkins Dec 1, 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5184-8ae6060f67c534dbc92bba9e882ac549b45b43eb0ffd0e84a6044ebde9a792ff3</citedby><cites>FETCH-LOGICAL-c5184-8ae6060f67c534dbc92bba9e882ac549b45b43eb0ffd0e84a6044ebde9a792ff3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,781,785,886,27929,27930</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27171743$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Okello, Samson</creatorcontrib><creatorcontrib>Asiimwe, Stephen B</creatorcontrib><creatorcontrib>Kanyesigye, Michael</creatorcontrib><creatorcontrib>Muyindike, Winnie R</creatorcontrib><creatorcontrib>Boum, Yap</creatorcontrib><creatorcontrib>Mwebesa, Bosco Bwana</creatorcontrib><creatorcontrib>Haberer, Jessica E</creatorcontrib><creatorcontrib>Huang, Yong</creatorcontrib><creatorcontrib>Williams, Kenneth</creatorcontrib><creatorcontrib>Burdo, Tricia H</creatorcontrib><creatorcontrib>Tracy, Russell P</creatorcontrib><creatorcontrib>Bangsberg, David R</creatorcontrib><creatorcontrib>Mocello, A Rain</creatorcontrib><creatorcontrib>Martin, Jeffrey N</creatorcontrib><creatorcontrib>Hunt, Peter W</creatorcontrib><creatorcontrib>Siedner, Mark J</creatorcontrib><title>D-dimer levels and traditional risk factors are associated with incident hypertension among HIV-infected individuals initiating antiretroviral therapy in Uganda</title><title>Journal of acquired immune deficiency syndromes (1999)</title><addtitle>J Acquir Immune Defic Syndr</addtitle><description>OBJECTIVES:We sought to describe blood pressure changes after antiretroviral therapy (ART) initiation and evaluate the association of markers of inflammation with incident hypertension in a cohort of HIV-individuals in Uganda.
METHODS:We used mixed effects linear regression to model changes in systolic blood pressure (BP) over time among a cohort of HIV-infected individuals initiating ART in Uganda. After exclusion of participants with pre-existing hypertension, we identified participants with normal BP throughout follow-up (controls) and those with elevated BP on ≥3 consecutive visits (cases). Prior to ART initiation, participants had testing for lnterleukin-6, kynurenine/tryptophan ratio, lipopolysaccharide, soluble CD14, soluble CD163, and D-dimer and those with viral suppression at six months during ART had repeat tests. We fit logistic regression models to estimate associations between biomarkers and risk of incident hypertension.
RESULTS:In the entire cohort, systolic BP increased by 9.6 mmHg/year (95% CI 7.3 - 11.8) in the first six months of ART, then plateaued. Traditional factorsmale gender (AOR 2.76, 95% CI 1.34-5.68), age (AOR 1.09, 95% CI 1.04-1.13), overweight (AOR 4.48, 95%CI 1.83-10.97), and a CD4 count < 100 cells (AOR 3.08, 95% CI 1.07-8.89) were associated with incident hypertension. After adjusting for these, D-dimer levels at month 6 were inversely associated with incident hypertension (AOR 0.61, 95% CI 0.37-0.99). Although not significant, similar associations were seen with sCD14 and Kynurenine/Tryptophan (K/T) ratio.
CONCLUSION:Blood pressure increases early after ART initiation in Ugandans. Traditional risk factors, rather than immune activation were associated with incident hypertension in this population.</description><subject>Adult</subject><subject>AIDS/HIV</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antihypertensive Agents - administration & dosage</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Antiretroviral drugs</subject><subject>Biomarkers</subject><subject>Cytokines</subject><subject>Female</subject><subject>Fibrin Fibrinogen Degradation Products - metabolism</subject><subject>HIV</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - drug therapy</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - drug therapy</subject><subject>Hypertension - etiology</subject><subject>Lentivirus</subject><subject>Male</subject><subject>Regression analysis</subject><subject>Retroviridae</subject><subject>Risk Factors</subject><issn>1525-4135</issn><issn>1944-7884</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNktFqFDEUhgdRbK2-gUjAG2-mZmaSmeRGKNXahYII1tuQSc7spJ1N1iSzy76Nj9qzbC21F2JykUC-_z_nkL8o3lb0tKKy-_j9bHFKH62KduxZcVxJxspOCPYc77zmJasaflS8SukGmZYx-bI4qrsKN2uOi9-fS-tWEMkEG5gS0d6SHLV12QWvJxJduiWDNjlEfIxAdErBOJ3Bkq3LI3HeOAs-k3G3hpjBJxQSvQp-SS4XP0vnBzB72nnrNs7OGqs4j_46O2S0zy5CjmHjItbLI0S93iFBrpfYjH5dvBhQAm_uz5Pi-uLLj_PL8urb18X52VVpeCVYKTS0tKVD2xneMNsbWfe9liBErQ1nsme8Zw30dBgsBcF0SxmD3oLUnayHoTkpPh1813O_AmtwJOxHraNb6bhTQTv194t3o1qGjeJUcCEoGny4N4jh1wwpq5VLBqZJewhzUpXgtBOypvI_0LptO8GaBtH3T9CbMEf8mT3VdLxpWyGQYgfKxJBShOGh74qqfVoUpkU9TQvK3j2e-UH0Jx4IiAOwDVOGmG6neQtRjaCnPP7b-w72jdCW</recordid><startdate>20161201</startdate><enddate>20161201</enddate><creator>Okello, Samson</creator><creator>Asiimwe, Stephen B</creator><creator>Kanyesigye, Michael</creator><creator>Muyindike, Winnie R</creator><creator>Boum, Yap</creator><creator>Mwebesa, Bosco Bwana</creator><creator>Haberer, Jessica E</creator><creator>Huang, Yong</creator><creator>Williams, Kenneth</creator><creator>Burdo, Tricia H</creator><creator>Tracy, Russell P</creator><creator>Bangsberg, David R</creator><creator>Mocello, A Rain</creator><creator>Martin, Jeffrey N</creator><creator>Hunt, Peter W</creator><creator>Siedner, Mark J</creator><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7T5</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>7U2</scope><scope>5PM</scope></search><sort><creationdate>20161201</creationdate><title>D-dimer levels and traditional risk factors are associated with incident hypertension among HIV-infected individuals initiating antiretroviral therapy in Uganda</title><author>Okello, Samson ; Asiimwe, Stephen B ; Kanyesigye, Michael ; Muyindike, Winnie R ; Boum, Yap ; Mwebesa, Bosco Bwana ; Haberer, Jessica E ; Huang, Yong ; Williams, Kenneth ; Burdo, Tricia H ; Tracy, Russell P ; Bangsberg, David R ; Mocello, A Rain ; Martin, Jeffrey N ; Hunt, Peter W ; Siedner, Mark J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5184-8ae6060f67c534dbc92bba9e882ac549b45b43eb0ffd0e84a6044ebde9a792ff3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>AIDS/HIV</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Antihypertensive Agents - administration & dosage</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Antiretroviral drugs</topic><topic>Biomarkers</topic><topic>Cytokines</topic><topic>Female</topic><topic>Fibrin Fibrinogen Degradation Products - metabolism</topic><topic>HIV</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - drug therapy</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - drug therapy</topic><topic>Hypertension - etiology</topic><topic>Lentivirus</topic><topic>Male</topic><topic>Regression analysis</topic><topic>Retroviridae</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Okello, Samson</creatorcontrib><creatorcontrib>Asiimwe, Stephen B</creatorcontrib><creatorcontrib>Kanyesigye, Michael</creatorcontrib><creatorcontrib>Muyindike, Winnie R</creatorcontrib><creatorcontrib>Boum, Yap</creatorcontrib><creatorcontrib>Mwebesa, Bosco Bwana</creatorcontrib><creatorcontrib>Haberer, Jessica E</creatorcontrib><creatorcontrib>Huang, Yong</creatorcontrib><creatorcontrib>Williams, Kenneth</creatorcontrib><creatorcontrib>Burdo, Tricia H</creatorcontrib><creatorcontrib>Tracy, Russell P</creatorcontrib><creatorcontrib>Bangsberg, David R</creatorcontrib><creatorcontrib>Mocello, A Rain</creatorcontrib><creatorcontrib>Martin, Jeffrey N</creatorcontrib><creatorcontrib>Hunt, Peter W</creatorcontrib><creatorcontrib>Siedner, Mark J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>Safety Science and Risk</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Okello, Samson</au><au>Asiimwe, Stephen B</au><au>Kanyesigye, Michael</au><au>Muyindike, Winnie R</au><au>Boum, Yap</au><au>Mwebesa, Bosco Bwana</au><au>Haberer, Jessica E</au><au>Huang, Yong</au><au>Williams, Kenneth</au><au>Burdo, Tricia H</au><au>Tracy, Russell P</au><au>Bangsberg, David R</au><au>Mocello, A Rain</au><au>Martin, Jeffrey N</au><au>Hunt, Peter W</au><au>Siedner, Mark J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>D-dimer levels and traditional risk factors are associated with incident hypertension among HIV-infected individuals initiating antiretroviral therapy in Uganda</atitle><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle><addtitle>J Acquir Immune Defic Syndr</addtitle><date>2016-12-01</date><risdate>2016</risdate><volume>73</volume><issue>4</issue><spage>396</spage><epage>402</epage><pages>396-402</pages><issn>1525-4135</issn><eissn>1944-7884</eissn><coden>JDSRET</coden><abstract>OBJECTIVES:We sought to describe blood pressure changes after antiretroviral therapy (ART) initiation and evaluate the association of markers of inflammation with incident hypertension in a cohort of HIV-individuals in Uganda.
METHODS:We used mixed effects linear regression to model changes in systolic blood pressure (BP) over time among a cohort of HIV-infected individuals initiating ART in Uganda. After exclusion of participants with pre-existing hypertension, we identified participants with normal BP throughout follow-up (controls) and those with elevated BP on ≥3 consecutive visits (cases). Prior to ART initiation, participants had testing for lnterleukin-6, kynurenine/tryptophan ratio, lipopolysaccharide, soluble CD14, soluble CD163, and D-dimer and those with viral suppression at six months during ART had repeat tests. We fit logistic regression models to estimate associations between biomarkers and risk of incident hypertension.
RESULTS:In the entire cohort, systolic BP increased by 9.6 mmHg/year (95% CI 7.3 - 11.8) in the first six months of ART, then plateaued. Traditional factorsmale gender (AOR 2.76, 95% CI 1.34-5.68), age (AOR 1.09, 95% CI 1.04-1.13), overweight (AOR 4.48, 95%CI 1.83-10.97), and a CD4 count < 100 cells (AOR 3.08, 95% CI 1.07-8.89) were associated with incident hypertension. After adjusting for these, D-dimer levels at month 6 were inversely associated with incident hypertension (AOR 0.61, 95% CI 0.37-0.99). Although not significant, similar associations were seen with sCD14 and Kynurenine/Tryptophan (K/T) ratio.
CONCLUSION:Blood pressure increases early after ART initiation in Ugandans. Traditional risk factors, rather than immune activation were associated with incident hypertension in this population.</abstract><cop>United States</cop><pub>Copyright Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>27171743</pmid><doi>10.1097/QAI.0000000000001074</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult AIDS/HIV Anti-HIV Agents - therapeutic use Antihypertensive Agents - administration & dosage Antihypertensive Agents - therapeutic use Antiretroviral drugs Biomarkers Cytokines Female Fibrin Fibrinogen Degradation Products - metabolism HIV HIV Infections - complications HIV Infections - drug therapy Human immunodeficiency virus Humans Hypertension Hypertension - drug therapy Hypertension - etiology Lentivirus Male Regression analysis Retroviridae Risk Factors |
| title | D-dimer levels and traditional risk factors are associated with incident hypertension among HIV-infected individuals initiating antiretroviral therapy in Uganda |
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