Evaluation of New Hypertension Guidelines on the Prevalence and Control of Hypertension in a Clinical HIV Cohort: A Community-Based Study

Authors

Vishnu Priya Mallipeddi, Department of Cardiovascular Sciences, Louisiana State University Health Shreveport, Shreveport, Louisiana.
Matthew Levy, Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.
Morgan Byrne, Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.
Anne Monroe, Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.
Lindsey Powers Happ, Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.
Letumile Rodgers Moeng, Department of Internal Medicine, Division of Infectious Diseases, Howard University, Washington, District of Columbia, USA.
Amanda D. Castel, Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.
Michael Horberg, Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, Maryland, USA.
Ronald Wilcox, Department of Internal Medicine, Division of Infectious Diseases, Howard University, Washington, District of Columbia, USA.

Document Type

Journal Article

Publication Date

9-7-2023

Journal

AIDS research and human retroviruses

DOI

10.1089/AID.2022.0063

Keywords

HIV; hypertension

Abstract

The prevalence and control of hypertension (HTN) among people with HIV (PWH) have not been widely studied since the release of newer 2017 ACC/AHA guidelines ("new guidelines"). To address this research gap, we evaluated and compared the prevalence and control of HTN using both 2003 JNC 7 ("old guidelines") and new guidelines. We identified 3,206 PWH with HTN from the DC Cohort study in Washington, DC, between January 2018 and June 2019. We defined HTN using International Classification of Diseases (ICD)-9/-10 diagnosis codes for HTN or ≥2 blood pressure (BP) measurements obtained at least 1 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 (aOR); 95% confidence interval (CI)]. 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/≥90 mm 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). 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 suggest that more aggressive HTN control is warranted among PWH, with additional attention to younger patients and non-Hispanic Black patients.

APA Citation

Mallipeddi, Vishnu Priya; Levy, Matthew; Byrne, Morgan; Monroe, Anne; Happ, Lindsey Powers; Moeng, Letumile Rodgers; Castel, Amanda D.; 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 3439.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3439

Department

Epidemiology