Blood pressure and mortality in a prospective cohort of HIV-infected adults in Port-au-Prince, Haiti
OBJECTIVE:The objective of this study was to determine how baseline blood pressure and incident hypertension related to antiretroviral therapy (ART) initiation, HIV-related inflammation and mortality in HIV-infected adults in a low-income country. METHODS:We conducted long-term follow-up of HIV-infe...
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| Veröffentlicht in: | Journal of hypertension 2018-07, Vol.36 (7), p.1533-1539 |
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| container_title | Journal of hypertension |
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| creator | Batavia, Ashita S Severe, Patrice Lee, Myung Hee Apollon, Alexandra Zhu, Yuan Shan Dupnik, Kathryn M McNairy, Margaret L Pape, Jean W Fitzgerald, Daniel W Peck, Robert N |
| description | OBJECTIVE:The objective of this study was to determine how baseline blood pressure and incident hypertension related to antiretroviral therapy (ART) initiation, HIV-related inflammation and mortality in HIV-infected adults in a low-income country.
METHODS:We conducted long-term follow-up of HIV-infected adults who had participated in a trial of early vs. delayed initiation of ART in Port-au-Prince, Haiti. Between 2005 and 2008, 816 HIV-infected adults were randomized to early (N = 408) vs. delayed ART (when CD4 cell count |
| doi_str_mv | 10.1097/HJH.0000000000001723 |
| format | Article |
| fullrecord | <record><control><sourceid>pubmed_cross</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5976542</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>29634661</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4573-367e0bf52fb709df9ea9ea49fe4e0e235e58c120e609fcae94d5a46c33d23ae93</originalsourceid><addsrcrecordid>eNp9UNtOGzEQtRCIpJQ_QJU_gAWvbxu_ILUR7aZCIg_QV8uxx43bzTqyd4n4-zpKQdCHjiyNxucy9kHooiZXNVHNdfu9vSJvqm4oO0LTmjesEkLNjtGUUMkqyQSdoA85_yqkmWrYKZpQJRmXsp4i96WL0eFtgpzHBNj0Dm9iGkwXhmccemwKFvMW7BCeANu4LiCOHreLH1XofbkHh40buyHv6csCV2aslin0Fi5xa8IQPqITb7oM53_7GXr8evswb6u7-2-L-ee7ynJRXs1kA2TlBfWrhijnFZhyuPLAgQBlAsTM1pSAJMpbA4o7Ybi0jDnKysjO0M3BdzuuNuAs9EMynd6msDHpWUcT9HukD2v9Mz5poRopOC0G_GBgy59zAv-qrYnep65L6vrf1Ivs09u9r6KXmAthdiDsYjdAyr-7cQdJr8F0w_r_3n8A9ZKQ2A</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Blood pressure and mortality in a prospective cohort of HIV-infected adults in Port-au-Prince, Haiti</title><source>Journals@Ovid Ovid Autoload</source><source>MEDLINE</source><creator>Batavia, Ashita S ; Severe, Patrice ; Lee, Myung Hee ; Apollon, Alexandra ; Zhu, Yuan Shan ; Dupnik, Kathryn M ; McNairy, Margaret L ; Pape, Jean W ; Fitzgerald, Daniel W ; Peck, Robert N</creator><creatorcontrib>Batavia, Ashita S ; Severe, Patrice ; Lee, Myung Hee ; Apollon, Alexandra ; Zhu, Yuan Shan ; Dupnik, Kathryn M ; McNairy, Margaret L ; Pape, Jean W ; Fitzgerald, Daniel W ; Peck, Robert N</creatorcontrib><description>OBJECTIVE:The objective of this study was to determine how baseline blood pressure and incident hypertension related to antiretroviral therapy (ART) initiation, HIV-related inflammation and mortality in HIV-infected adults in a low-income country.
METHODS:We conducted long-term follow-up of HIV-infected adults who had participated in a trial of early vs. delayed initiation of ART in Port-au-Prince, Haiti. Between 2005 and 2008, 816 HIV-infected adults were randomized to early (N = 408) vs. delayed ART (when CD4 cell count <200 cells/μl or AIDS-defining condition; N = 408). Blood pressure was measured every 3 months. Hypertension was diagnosed according to the Joint National Committee (JNC-7) guidelines. Biomarkers of inflammation and coagulation were measured from banked enrolment plasma samples. Survival analyses were performed using Stata 14.
RESULTS:The median age at enrolment was 39 years. The median follow-up time was 7.3 years. The hypertension incidence rate was 3.41 per 100 person-years, and was similar in early and delayed ART groups. In multivariable models, independent predictors of incident hypertension were older age, higher BMI and plasma interleukin (IL)-6 levels (adjusted hazard ratio, aHR = 1.23, P < 0.001). Systolic pressure more than 140 mmHg at enrolment was associated with increased mortality (aHR = 2.47, P = 0.03) as was systolic pressure less than 90 mmHg (aHR = 2.25, P = 0.04). Prevalent and incident hypertension were also significantly associated with mortality.
CONCLUSION:In a large prospective study of HIV-infected adults, we found a high incidence of hypertension associated with HIV-related inflammation. Baseline hypertension conferred a more than two-fold increased risk of death. Among HIV-infected adults in low-income countries, hypertension should be considered a serious threat to long-term survival.</description><identifier>ISSN: 0263-6352</identifier><identifier>EISSN: 1473-5598</identifier><identifier>DOI: 10.1097/HJH.0000000000001723</identifier><identifier>PMID: 29634661</identifier><language>eng</language><publisher>Netherlands: Copyright Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Adult ; Age Factors ; Anti-HIV Agents - therapeutic use ; Blood Pressure ; Body Mass Index ; CD4 Lymphocyte Count ; Developing Countries ; Female ; Follow-Up Studies ; Haiti - epidemiology ; HIV Infections - complications ; HIV Infections - drug therapy ; HIV Infections - immunology ; HIV Infections - mortality ; Humans ; Hypertension - epidemiology ; Hypertension - physiopathology ; Incidence ; Inflammation - blood ; Inflammation - virology ; Interleukin-6 - blood ; Male ; Middle Aged ; Prevalence ; Proportional Hazards Models ; Prospective Studies ; Time-to-Treatment</subject><ispartof>Journal of hypertension, 2018-07, Vol.36 (7), p.1533-1539</ispartof><rights>Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4573-367e0bf52fb709df9ea9ea49fe4e0e235e58c120e609fcae94d5a46c33d23ae93</citedby><cites>FETCH-LOGICAL-c4573-367e0bf52fb709df9ea9ea49fe4e0e235e58c120e609fcae94d5a46c33d23ae93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29634661$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Batavia, Ashita S</creatorcontrib><creatorcontrib>Severe, Patrice</creatorcontrib><creatorcontrib>Lee, Myung Hee</creatorcontrib><creatorcontrib>Apollon, Alexandra</creatorcontrib><creatorcontrib>Zhu, Yuan Shan</creatorcontrib><creatorcontrib>Dupnik, Kathryn M</creatorcontrib><creatorcontrib>McNairy, Margaret L</creatorcontrib><creatorcontrib>Pape, Jean W</creatorcontrib><creatorcontrib>Fitzgerald, Daniel W</creatorcontrib><creatorcontrib>Peck, Robert N</creatorcontrib><title>Blood pressure and mortality in a prospective cohort of HIV-infected adults in Port-au-Prince, Haiti</title><title>Journal of hypertension</title><addtitle>J Hypertens</addtitle><description>OBJECTIVE:The objective of this study was to determine how baseline blood pressure and incident hypertension related to antiretroviral therapy (ART) initiation, HIV-related inflammation and mortality in HIV-infected adults in a low-income country.
METHODS:We conducted long-term follow-up of HIV-infected adults who had participated in a trial of early vs. delayed initiation of ART in Port-au-Prince, Haiti. Between 2005 and 2008, 816 HIV-infected adults were randomized to early (N = 408) vs. delayed ART (when CD4 cell count <200 cells/μl or AIDS-defining condition; N = 408). Blood pressure was measured every 3 months. Hypertension was diagnosed according to the Joint National Committee (JNC-7) guidelines. Biomarkers of inflammation and coagulation were measured from banked enrolment plasma samples. Survival analyses were performed using Stata 14.
RESULTS:The median age at enrolment was 39 years. The median follow-up time was 7.3 years. The hypertension incidence rate was 3.41 per 100 person-years, and was similar in early and delayed ART groups. In multivariable models, independent predictors of incident hypertension were older age, higher BMI and plasma interleukin (IL)-6 levels (adjusted hazard ratio, aHR = 1.23, P < 0.001). Systolic pressure more than 140 mmHg at enrolment was associated with increased mortality (aHR = 2.47, P = 0.03) as was systolic pressure less than 90 mmHg (aHR = 2.25, P = 0.04). Prevalent and incident hypertension were also significantly associated with mortality.
CONCLUSION:In a large prospective study of HIV-infected adults, we found a high incidence of hypertension associated with HIV-related inflammation. Baseline hypertension conferred a more than two-fold increased risk of death. Among HIV-infected adults in low-income countries, hypertension should be considered a serious threat to long-term survival.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Blood Pressure</subject><subject>Body Mass Index</subject><subject>CD4 Lymphocyte Count</subject><subject>Developing Countries</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Haiti - epidemiology</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - immunology</subject><subject>HIV Infections - mortality</subject><subject>Humans</subject><subject>Hypertension - epidemiology</subject><subject>Hypertension - physiopathology</subject><subject>Incidence</subject><subject>Inflammation - blood</subject><subject>Inflammation - virology</subject><subject>Interleukin-6 - blood</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prevalence</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Time-to-Treatment</subject><issn>0263-6352</issn><issn>1473-5598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UNtOGzEQtRCIpJQ_QJU_gAWvbxu_ILUR7aZCIg_QV8uxx43bzTqyd4n4-zpKQdCHjiyNxucy9kHooiZXNVHNdfu9vSJvqm4oO0LTmjesEkLNjtGUUMkqyQSdoA85_yqkmWrYKZpQJRmXsp4i96WL0eFtgpzHBNj0Dm9iGkwXhmccemwKFvMW7BCeANu4LiCOHreLH1XofbkHh40buyHv6csCV2aslin0Fi5xa8IQPqITb7oM53_7GXr8evswb6u7-2-L-ee7ynJRXs1kA2TlBfWrhijnFZhyuPLAgQBlAsTM1pSAJMpbA4o7Ybi0jDnKysjO0M3BdzuuNuAs9EMynd6msDHpWUcT9HukD2v9Mz5poRopOC0G_GBgy59zAv-qrYnep65L6vrf1Ivs09u9r6KXmAthdiDsYjdAyr-7cQdJr8F0w_r_3n8A9ZKQ2A</recordid><startdate>201807</startdate><enddate>201807</enddate><creator>Batavia, Ashita S</creator><creator>Severe, Patrice</creator><creator>Lee, Myung Hee</creator><creator>Apollon, Alexandra</creator><creator>Zhu, Yuan Shan</creator><creator>Dupnik, Kathryn M</creator><creator>McNairy, Margaret L</creator><creator>Pape, Jean W</creator><creator>Fitzgerald, Daniel W</creator><creator>Peck, Robert N</creator><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</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>5PM</scope></search><sort><creationdate>201807</creationdate><title>Blood pressure and mortality in a prospective cohort of HIV-infected adults in Port-au-Prince, Haiti</title><author>Batavia, Ashita S ; Severe, Patrice ; Lee, Myung Hee ; Apollon, Alexandra ; Zhu, Yuan Shan ; Dupnik, Kathryn M ; McNairy, Margaret L ; Pape, Jean W ; Fitzgerald, Daniel W ; Peck, Robert N</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4573-367e0bf52fb709df9ea9ea49fe4e0e235e58c120e609fcae94d5a46c33d23ae93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Blood Pressure</topic><topic>Body Mass Index</topic><topic>CD4 Lymphocyte Count</topic><topic>Developing Countries</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Haiti - epidemiology</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - immunology</topic><topic>HIV Infections - mortality</topic><topic>Humans</topic><topic>Hypertension - epidemiology</topic><topic>Hypertension - physiopathology</topic><topic>Incidence</topic><topic>Inflammation - blood</topic><topic>Inflammation - virology</topic><topic>Interleukin-6 - blood</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prevalence</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Time-to-Treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Batavia, Ashita S</creatorcontrib><creatorcontrib>Severe, Patrice</creatorcontrib><creatorcontrib>Lee, Myung Hee</creatorcontrib><creatorcontrib>Apollon, Alexandra</creatorcontrib><creatorcontrib>Zhu, Yuan Shan</creatorcontrib><creatorcontrib>Dupnik, Kathryn M</creatorcontrib><creatorcontrib>McNairy, Margaret L</creatorcontrib><creatorcontrib>Pape, Jean W</creatorcontrib><creatorcontrib>Fitzgerald, Daniel W</creatorcontrib><creatorcontrib>Peck, Robert N</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of hypertension</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Batavia, Ashita S</au><au>Severe, Patrice</au><au>Lee, Myung Hee</au><au>Apollon, Alexandra</au><au>Zhu, Yuan Shan</au><au>Dupnik, Kathryn M</au><au>McNairy, Margaret L</au><au>Pape, Jean W</au><au>Fitzgerald, Daniel W</au><au>Peck, Robert N</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Blood pressure and mortality in a prospective cohort of HIV-infected adults in Port-au-Prince, Haiti</atitle><jtitle>Journal of hypertension</jtitle><addtitle>J Hypertens</addtitle><date>2018-07</date><risdate>2018</risdate><volume>36</volume><issue>7</issue><spage>1533</spage><epage>1539</epage><pages>1533-1539</pages><issn>0263-6352</issn><eissn>1473-5598</eissn><abstract>OBJECTIVE:The objective of this study was to determine how baseline blood pressure and incident hypertension related to antiretroviral therapy (ART) initiation, HIV-related inflammation and mortality in HIV-infected adults in a low-income country.
METHODS:We conducted long-term follow-up of HIV-infected adults who had participated in a trial of early vs. delayed initiation of ART in Port-au-Prince, Haiti. Between 2005 and 2008, 816 HIV-infected adults were randomized to early (N = 408) vs. delayed ART (when CD4 cell count <200 cells/μl or AIDS-defining condition; N = 408). Blood pressure was measured every 3 months. Hypertension was diagnosed according to the Joint National Committee (JNC-7) guidelines. Biomarkers of inflammation and coagulation were measured from banked enrolment plasma samples. Survival analyses were performed using Stata 14.
RESULTS:The median age at enrolment was 39 years. The median follow-up time was 7.3 years. The hypertension incidence rate was 3.41 per 100 person-years, and was similar in early and delayed ART groups. In multivariable models, independent predictors of incident hypertension were older age, higher BMI and plasma interleukin (IL)-6 levels (adjusted hazard ratio, aHR = 1.23, P < 0.001). Systolic pressure more than 140 mmHg at enrolment was associated with increased mortality (aHR = 2.47, P = 0.03) as was systolic pressure less than 90 mmHg (aHR = 2.25, P = 0.04). Prevalent and incident hypertension were also significantly associated with mortality.
CONCLUSION:In a large prospective study of HIV-infected adults, we found a high incidence of hypertension associated with HIV-related inflammation. Baseline hypertension conferred a more than two-fold increased risk of death. Among HIV-infected adults in low-income countries, hypertension should be considered a serious threat to long-term survival.</abstract><cop>Netherlands</cop><pub>Copyright Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>29634661</pmid><doi>10.1097/HJH.0000000000001723</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | Journals@Ovid Ovid Autoload; MEDLINE |
| subjects | Adult Age Factors Anti-HIV Agents - therapeutic use Blood Pressure Body Mass Index CD4 Lymphocyte Count Developing Countries Female Follow-Up Studies Haiti - epidemiology HIV Infections - complications HIV Infections - drug therapy HIV Infections - immunology HIV Infections - mortality Humans Hypertension - epidemiology Hypertension - physiopathology Incidence Inflammation - blood Inflammation - virology Interleukin-6 - blood Male Middle Aged Prevalence Proportional Hazards Models Prospective Studies Time-to-Treatment |
| title | Blood pressure and mortality in a prospective cohort of HIV-infected adults in Port-au-Prince, Haiti |
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