Evaluation of New Hypertension Guidelines on the Prevalence and Control of Hypertension in a Clinical HIV Cohort: A Community-Based Study
AIDS research and human retroviruses
INTRODUCTION The prevalence and control of HTN among people with HIV (PWH) have not been widely studied since the release of newer 2017 ACC/AHA guidelines ("new guidelines"). Hence, we evaluated the prevalence and control of HTN using both 2003 JNC 7 ("old guidelines") and new guidelines. METHODS We identified 3206 PWH with HTN from the DC Cohort study in Washington, D.C, between 01/2018 and 06/2019. We defined HTN using International Classification of Diseases (ICD) -9/-10 diagnosis codes for HTN or ≥2 BP measurements obtained at least one month apart (>139/89 mm Hg per old or >129/79 mm Hg per new guidelines). We defined HTN control based on recent BP (≤129/≤79 mm Hg per new guidelines). We identified socio-demographics, cardiovascular risk factors and co-morbidities associated with HTN control using multivariable logistic regression (adjusted Odds Ratio; 95% CI). RESULTS The prevalence of HTN was 50.9 % per old versus 62.2% per new guidelines. Of the 3,206 PWH with HTN 887 (27.7%) had a recent BP ≤129/≤79 mm Hg, 1,196 (37.3%) had a BP 130-139/80-89 mm Hg and 1,123 (35.0%) had a BP ≥140/≥90mm Hg. After adjusting for socio-demographics, cardiovascular risk factors and co-morbidities, factors associated with HTN control included age 60-69 (vs. <40) years (aOR 1.42; 95 % CI 1.03-1.98), Hispanic (vs. non-Hispanic Black) race/ethnicity (aOR 1.49; 95 % CI 1.04-2.15), receipt of HIV care at a hospital-based (vs. community-based) clinic (aOR 1.21; 95 % CI 1.00-1.47), being unemployed (aOR 1.42; 95% CI 1.11-1.83), and diabetes (aOR 1.35; 95% CI 1.13-1.63). CONCLUSION In a large urban cohort of PWH, nearly two-thirds had HTN and less than one-third of those met new guideline criteria. Our data suggests that more aggressive HTN control is warranted among PWH, with additional attention to younger patients and non-Hispanic Black patients.
Mallipeddi, Vishnu Priya; Levy, Matthew; Byrne, Morgan; Monroe, Anne; Happ, Lindsey; Moeng, Letumile Rodgers; Castel, Amanda; Horberg, Michael; and Wilcox, Ronald, "Evaluation of New Hypertension Guidelines on the Prevalence and Control of Hypertension in a Clinical HIV Cohort: A Community-Based Study" (2023). GW Authored Works. Paper 3303.