The Prevalence Of Hypertension And Hyperglycemia And Associated Factors Among HIV-infected Persons Receiving Antiretroviral Treatment In A Beijing Hospital

ObjectiveTo investigate the prevalence of hypertension and hyperglycemia among HIV-infected individuals taking antiretroviral therapy (ART) in a hospital AIDS outpatient in Beijing, and analyze the factors associated with hypertension or hyperglycemia (including factors related or not related to HIV as well as related to ART), just to provide scientific reference for the better control of blood pressure and blood sugar among HIV-infected individuals.MethodsCross-sectional survey was conducted by using convenience sampling from May to July in2013in a hospital outpatient in Beijing. The on-site survey content included basic demographic information, hypertension or hyperglycemia associated factors in general population, HIV-related information and ART information.Non-conditional logistic regression was performed to explore whether the factor was associated with hypertension or high blood sugar. Then factors with P <0.05from the result of the univariate analysis were put into multivariate logistic regression analysis to observe whether certain factors were associated with hypertension or hyperglycemia under the condition of controlling for other factors.ResultsThere were739people participating in the on-site investigation. Among those patients,591subjects met the inclusion criteria for the study of hypertension, and504subjects for the study of hyperglycemia. 1. Among591HIV-infected individuals included into the study of hypertension, the number of people with hypertension was137(39of whom were currently taking antihypertensive medications).As a result, the prevalence of hypertension was23.2%. Trend analysis showed that the prevalence of hypertension increased with increasing age (Z=-5.548, P=0.001), with increasing ART time (Z=-2.450, P=0.05).While the prevalence of high blood pressure didn’t have the trend change with the nadir CD4T lymphocyte count (Z=-1.358, P=0.301) and recent CD4T lymphocyte count (Z=0.261, P=0.781).2. Univariate analysis showed that age per10years increase (OR=1.75,95%CI:1.47-2.10,P=0.001), minority(OR=0.20,95%CI:0.05-0.86,P=0.030), married or cohabiting (OR=1.51,95%CI:1.08-2.22,P=0.035), no exercise (OR=2.62,95%CI:1.65-4.17, P=0.001), like salty food (OR=2.02,95%CI:1.28-3.20,^=0.003), family history of hypertension (OR=1.61,95%CI:1.08-2.39, P=0.019), overweight (OR=3.99,95%CI:2.62-6.07, P=0.001) and ART time per12months increase (OR=1.16,95%CI:1.05-1.28, P=0.004) were associated with hypertension, while sex, route of transmission, smoking, drinking, recent CD4T lymphocyte count, and nadir CD4T lymphocyte count and current ART regimens were not associated with hypertension.3. Multivariate logistic regression analysis showed that for each additional10years of ages, the prevalence of hypertension increased tol.63times (OR=1.63,95%CI:1.32-2.03, P=0.001); Compared with patients who had no family history of hypertension, individuals who had a family history of hypertension had greater risk of being hypertension(OR=1.61,95%CI:1.00-2.46,P=0.048); Compared with individuals whose body mass index was in the normal range, individuals with overweight had greater risk of being hypertension (OR=3.80,95%CI:2.40-6.03, P=0.001); individuals who didn’t exercise were more likely to have hypertension than individuals with exercise (OR=1.99,95%CI:1.18-3.36, P=0.010); Compared with individuals who didn’t like salty food, individuals who liked salty food had greater risk of being hypertension (OR=1.96,95%CI:1.17-3.28, P=0.011).4. Among504HIV-infected individuals included into the study of hyperglycemia, the number of people with hyperglycemia was79(18of whom were currently taking hypoglycemic drugs). As a result, the prevalence of hyperglycemia was15.7%. Trend analysis showed that the prevalence of high blood sugar increased with increasing age (Z=-3.07, P=0.002); with increasing ART time (Z=-2.08, P=0.037); with decrease of the nadir CD4T lymphocyte count (Z=-3.75, P=0.001), and the prevalence of hyperglycemia didn’t have the trend change with recent CD4T lymphocyte count (Z=1.145, P=0.252).5. Univariate analysis showed that age per10years old (OR=1.47,95%CI:1.18-1.82, P=0.001), married or cohabiting (OR=1.75,95%CI:1.08-2.84, P=0.023), no exercise (OR=2.49,95%CI:1.40-4.42, P=0.002), family history of diabetes (OR=2.76,95%CI:1.60-7.75, P=0.001),overweight(OR=2.22,95%CI:1.31-3.76, P=0.003), nadir CD4T lymphocyte count (OR=2.24,95%CI:1.28-3.93, P=0.005; OR=3.24,95%CI:1.66-6.20, P=0.001) and ART time per12months increase (OR=1.16,95%CI:1.03-1.31, P=0.015) were associated with high blood sugar, while sex, ethnic,route of HIV transmission, smoking, alcohol consumption, recent CD4T lymphocyte count and current ART regimens were not associated with high blood sugar (P>0.05).6. Multivariate logistic regression analysis showed that for each additional10years of ages, the prevalence of hyperglycemia increased to1.29times (OR=1.29,95%CI:1.01-1.65,P=0.041); individuals who had genetic family history of diabetes were more likely to be high blood sugar than individuals without family history of diabetes (OR=2.74,95%CI:1.54-4.87, P=0.006); Compared with individuals whose body mass index was in the normal range, individuals with overweight had greater risk to be hyperglycemia(OR=2.14,95%CI:1.23-3.75,P=0.008); individuals who didn’t exercise were more likely to be high blood sugar than individual who had exercise(OR=2.50,95%CI:1.35-4.64, P=0.004); Compared with CD4T lymphocytes more than200cells/μl, individuals with CD4T lymphocytes less than50cells/μl (OR=2.86,95%CI:1.34-6.07,P=0.007) or with CD4T lymphocytes50-199cells/μl (OR=1.94,95%CI:1.06-3.55,P=0.031) were more likely to be hyperglycemia. Conclusions1. Hypertension and hyperglycemia were prevalent (hypertension:23.3%, hyperglycemia:15.7%) among HIV-infected individuals. Therefore, the results remind us to strengthen to monitor the change of blood pressure and blood glucose in HIV-infected individuals receiving ART so that we can get early detection and take measures to control blood pressure and blood sugar within normal range.2. Factors such as older age, overweight, lack of exercise, like salty food, family history of diabetes and so on among general population were also associated with hypertension or hyperglycemia among HIV-infected individuals. Therefore, for patients with those reversible factors such as obesity, no exercise, like salty food, they should be encouraged to adopt in reasonable diet and appropriate physical exercise, just to better prevent or control high blood pressure and high blood sugar.3. HIV-related factor such as nadir CD4T lymphocyte count less than200cells/μl was associated with high blood sugar. So patients who had appeared CD4T lymphocytes less than200cells/μl should be pay more attention to monitor the changes of blood glucose.4. ART-related factors such as ART time was not associated with hypertension or high blood sugar, and ART regimens that included protease inhibitors and not contain protease inhibitors didn’t have different impact on the hypertension or hyperglycemia.