February 04, 2018
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1 in 8 patients with HIV has undiagnosed hypertension

One in eight patients receiving care for HIV in the United States has undiagnosed and untreated hypertension, according to study results.

“Since [people living with HIV (PLWH)] may be at increased risk for hypertension and its complications, including cardiovascular disease, the importance of screening by providers, with the intent to effectively treat, cannot be overemphasized,” Oluwatosin Olaiya, MBChB, of the CDC’s Division of HIV/AIDS Prevention, and colleagues wrote in Open Forum Infectious Diseases.

The CDC estimates that 33.5% of adults aged 20 years and older in the U.S. general population have hypertension.

To estimate the prevalence of hypertension among PLWH, Olaiya and colleagues used data from the Medical Monitoring Project, a surveillance system designed to produce nationally representative estimates of behavioral and clinical characteristics of adults infected with HIV in the U.S. The data were collected through face-to-face or telephone interviews and medical record abstractions. The analysis included 8,631 patients in total.

Hypertension was categorized as “undiagnosed and untreated,” “diagnosed and treated” and “unclassified,” the researchers said.

Overall, 42.4% (95% CI, 40.4-44.5) of PLWH had hypertension, according to the results. Of those, 13.3% (95% CI, 11.7-14.9) were undiagnosed and untreated, 48.9% (95% CI, 46.7-51.1) were treated and controlled, 26.3% (95% CI 24.2-28.3) were treated and uncontrolled, and 11.5% (95% CI, 10.4-12.6%) were unclassified.

Hypertension was more prevalent among patients aged 50 years and older (P < .001) than younger patients. However, the prevalence of undiagnosed and untreated hypertension decreased as patients aged. Less than 10% of patients aged 50 years and older had undiagnosed and untreated hypertension compared with 39.1% of patients aged 18 to 29 years.

“We found that one in eight patients had undiagnosed and untreated hypertension,” the researchers wrote. “Providers may be missing opportunities for diagnosing and treating hypertension among patients who are younger, male, uninsured and recently incarcerated.”

Olaiya and colleagues suggested that providers are more focused on achieving viral suppression than addressing comorbidities in younger patients with HIV.

“With PLWH living longer lives as a result of highly active antiretroviral therapy, younger patients with undiagnosed and untreated hypertension potentially have many years to accrue complications of untreated and uncontrolled hypertension and therefore would benefit from early diagnosis and treatment,” the researchers wrote. – by Ryan McDonald

Disclosures: The researchers report no relevant financial disclosures.