title: Incidence of primary hypertension in a population-based cohort of HIV-infected compared with non-HIV-infected persons and the effect of combined antiretroviral therapy.
abstract: Literature remains scarce on the impact of antiretroviral medications on hypertension in the HIV population. We used the South Carolina Medicaid database linked with the enhanced HIV/AIDS system surveillance database for 1994-2011 to evaluate incident hypertension and the impact of combination antiretroviral therapy (cART) in HIV/AIDS population compared with a propensity- matched non-HIV control group. Multivariable, time-dependent survival analysis suggested no significant difference in incidence of hypertension between the HIV group and the non-HIV control group. However, subgroup analysis suggested that among the HIV-infected group, months of exposure to both non-nucleoside reverse transcriptase inhibitors (adjusted hazard ratio, 1.52; 95% confidence interval, 1.3-1.75) and protease inhibitors (adjusted hazard ratio, 1.26; 95% confidence interval, 1.11-1.44) were associated with an increased risk of incident hypertension after adjusting for traditional demographic and metabolic risk factors. In people with HIV/AIDS, prolonged exposure to both protease inhibitor-based and non-nucleoside reverse transcriptase inhibitor-based cART may increase the risk of incident hypertension.
authors.affiliation: Division of Internal Medicine, Department of Medicine, University of Mississippi School of Medicine, Jackson, MS, USA. Electronic address: atripathi@umc.edu.
authors.forename: Avnish
authors.initials: A
authors.lastname: Tripathi
authors.affiliation: Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, SC, USA.
authors.forename: Jeanette M
authors.initials: JM
authors.lastname: Jerrell
authors.affiliation: Division of Internal Medicine, Department of Medicine, University of Mississippi School of Medicine, Jackson, MS, USA.
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Skelton
authors.affiliation: Division of Internal Medicine, Department of Medicine, University of Mississippi School of Medicine, Jackson, MS, USA.
authors.forename: Myrna A
authors.initials: MA
authors.lastname: Nickels
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of South Carolina School of Medicine, Columbia, SC, USA.
authors.forename: Wayne A
authors.initials: WA
authors.lastname: Duffus
mesh_terms: D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D000075222:Essential Hypertension; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013022:South Carolina / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents
keywords: Enhanced HIV/AIDS surveillance; medicaid; non-nucleoside reverse transcriptase inhibitors; protease inhibitors