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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
Hypertension prevalence and Framinghamrisk score stratification in a largeHIV-positive cohort inUganda
Journal of Hypertension, Volume 31, No. 7, Year 2013
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Description
Background: To report the prevalence of hypertension and projected 10-year absolute risk of acute cardiovascular disease in a large prospectively followed cohort of HIVpositive youth and adults beginning antiretroviral therapy in sub-Saharan Africa. Methods: HIV-positive individuals seeking HIV treatment, ages 13 years and older, were assessed for repeated blood pressure measurements over the first year following initiation of antiretroviral therapy, including serum total cholesterol, high-density lipoprotein, CD4 cell count and related clinical and laboratory measurements. Outcomes include hypertension, defined according to the 7th Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure categories, and Framingham Risk Score based 10-year cardiovascular disease risk estimates. Results: Five thousand, five hundred and sixty-three patients had at least two blood pressure measurements on at least two separate occasions during the first year of antiretroviral therapy [median age of therapy initiation 34, first and third quartile (Q1-Q3) 28-40 years, 1841 (33.1%) men, baseline CD4 cell count 161 cells/ml (Q1-Q3 72-231 cells/ml]. Hypertension was diagnosed in 1551 patients [27.9%, 95% confidence interval (CI) 26.7-29.1] including 786 (14.1%, 95% CI 13.2-15.1) who met criteria for stage 2 hypertension. The age-standardized prevalence for Ugandans aged 13 or more was 24.8% (95% CI 23.8-26.1). Among those with complete laboratory studies (n=1102), nearly all women were in the 10% or less 10-year Framingham Risk Score category, but 20% of men were at at least 10% or more long-term risk of acute cardiovascular disease. Conclusion: Efforts to combine HIV treatment with vascular disease risk factor prevention and management are urgently needed to address noncommunicable disease multimorbidity in HIV-positive persons in sub-Saharan Africa, particularly in men. © Lippincott Williams and Wilkins.
Authors & Co-Authors
Mateen, Farrah J.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Kanters, Steve
Canada, Ottawa
University of Ottawa
Canada, Vancouver
The University of British Columbia
Kalyesubula, Robert
Uganda, Kampala
Makerere University
Mukasa, Barbara N.
Uganda, Kampala
Mildmay Uganda
Kawuma, Esther
Uganda, Kampala
Mildmay Uganda
Kengne, Andre-Pascal Pascal
South Africa, Tygerberg
South African Medical Research Council
Mills, Edward J.
Canada, Ottawa
University of Ottawa
Statistics
Citations: 87
Authors: 7
Affiliations: 6
Identifiers
Doi:
10.1097/HJH.0b013e328360de1c
ISSN:
02636352
e-ISSN:
14735598
Research Areas
Infectious Diseases
Noncommunicable Diseases
Study Design
Cross Sectional Study
Cohort Study
Participants Gender
Male
Female