title: Gender differences in the association of hazardous alcohol use with hypertension in an urban cohort of people living with HIV in South Florida.
abstract: OBJECTIVE
  Industrialized countries are currently experiencing an epidemic of high blood pressure (HBP) extending to people living with HIV (PLWH). Given the prevalence of hazardous alcohol use (HAU), this study examines the relationship between alcohol consumption and hypertension in PLWH. Including a gender analysis is critical, given the high rates of HAU and HIV among females.
  
  
  METHODS
  We followed PLWH including both HAU and non-HAU (200 each). Participants were assessed twice for body weight, blood pressure, alcohol consumption, and other BP-associated lifestyle factors. High blood pressure (defined as systolic/diastolic blood pressure above 140/90 mmHg and/or treatment of HBP) was the primary outcome.
  
  
  RESULTS
  Overall prevalence of hypertension was 38% and higher among HAU compared to non-HAU (42% vs. 34%, p = 0.02). Less than half with HBP (42%) were receiving treatment for hypertension. Overall, males had a 50% higher risk of HBP than women (odds ratio: 1.5, 95% CI: 1-2.6, p = 0.05). However among HAU, females were twice as likely to suffer HBP as their male counterparts (95% CI: 1-3.9, p = 0.02). Those HAU who preferred liquor, versus wine, had higher adjusted mean BP (132.6±18 vs. 122.3±14 mm Hg, p = 0.05). Additional analyses indicated that consumption of >1 standard drink of liquor or beer/day was associated with HBP. Risk of hypertension was noted in those with daily consumption of >3 glasses of wine. For those reporting <1 drink per day, the odds ratio of having HBP was 0.97 (CI: 0.6-0.99, p = 0.05). Factors associated with hypertension in the multivariate model included increased age, gender, BMI, HAU particularly of liquor, and smoking.
  
  
  CONCLUSIONS
  Excessive hypertension burden in this population and its association with HAU and sub-optimal care indicate the need for preventive and educational intervention in PLWH. Analyses highlight the necessity of gender and type-of-beverage specific approaches.
authors.affiliation: School of Integrated Science and Humanity (SISH), Florida International University, Miami, Florida, United States of America.
authors.forename: María José
authors.initials: MJ
authors.lastname: Míguez-Burbano
authors.affiliation: School of Integrated Science and Humanity (SISH), Florida International University, Miami, Florida, United States of America.
authors.forename: Clery
authors.initials: C
authors.lastname: Quiros
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, United States of America.
authors.forename: John E
authors.initials: JE
authors.lastname: Lewis
authors.affiliation: Division of Infectious Diseases, Miller School of Medicine, University of Miami, Miami, Florida, United States of America.
authors.forename: Luis
authors.initials: L
authors.lastname: Espinoza
authors.affiliation: Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Robert
authors.initials: R
authors.lastname: Cook
authors.affiliation: Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Allison B
authors.initials: AB
authors.lastname: Trainor
authors.affiliation: School of Integrated Science and Humanity (SISH), Florida International University, Miami, Florida, United States of America.
authors.forename: Erika
authors.initials: E
authors.lastname: Richardson
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Department of Pathology, Miller School of Medicine, University of Miami, Miami, Florida, United States of America.
authors.forename: Deshratn
authors.initials: D
authors.lastname: Asthana
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology*; D001794:Blood Pressure; D002947:Cities / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D005431:Florida / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012306:Risk; D017678:Sex Distribution