title: Burden, Determinants, and Pharmacological Management of Hypertension in HIV-Positive Patients and Populations: A Systematic Narrative Review.
abstract: Hypertension among HIV-positive populations has emerged as a new threat to the health and well being of people living with HIV, particularly among those receiving antiretroviral therapy. We reviewed the global evidence on the burden of disease (including prevalence and incidence), determinants of hypertension among HIV-positive populations, and the pharmacological management of hypertension in HIV-positive patients. We systematically searched PubMed-MEDLINE and EMBASE from January 2000 through February 2015 for relevant studies and traced their citations through the ISI Web of Science. We also searched the websites of the World Health Organisation, the International Society of Hypertension, and the International AIDS Society and constructed a narrative data synthesis. Hypertension is common in HIV-positive populations, with prevalence estimates ranging from 4.7 to 54.4% in high-income countries, and from 8.7 to 45.9% in low- and middle-income countries. The role of HIV-specific factors including disease severity, duration of disease, and treatments on the presence of hypertension in HIV-positive patients is reported, but patterns remain unclear. The clinical management of hypertension in HIV-positive patients is similar to those with hypertension in the general population; however, additional considerations should be given to potential drug interactions between antihypertensive agents and antiretroviral drugs to inform the clinician's selection of these therapies. Hypertension is common in HIV-positive populations and remains an important comorbidity affecting mortality outcomes. Further research examining the development of hypertension and its associated care in HIV-positive patients is required to optimize management of the dual conditions.
authors.affiliation: Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.|Department of Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Kim Anh
authors.initials: KA
authors.lastname: Nguyen
authors.affiliation: Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.|Department of Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Nasheeta
authors.initials: N
authors.lastname: Peer
authors.affiliation: Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Mills
authors.affiliation: Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.|Department of Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Andre Pascal
authors.initials: AP
authors.lastname: Kengne
mesh_terms: D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D004347:Drug Interactions; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012307:Risk Factors
chemical_list: D044966:Anti-Retroviral Agents; D000959:Antihypertensive Agents