Abstract Body: Introduction
Hypertension is associated with cardiometabolic and cardiovascular disease (CVD) risk especially in people with HIV (PWH) and the elderly. Lack of adherence to antihypertensive drugs heightens the CVD risk. Salt-sensitivity of blood pressure (SSBP), characterized by increases in blood pressure in response to increases in dietary salt intake is a risk factor for hypertension and HIV may likely increase this risk.
Aim
The goal of this study was to determine the differences in cardiometabolic and cardiovascular risk correlates of hypertension between PWH and HIV-negative.
Methods
We conducted a cross-sectional study at a large referral hospital in Zambia. We randomly sampled 132 adult PWH and HIV-negative individuals with known SSBP from an ongoing large cohort study. We conducted cardiovascular and metabolic phenotyping. Data was collected using research electronic data capture and analyzed using StatCrunch. We adjusted the multivariable analysis for age, sex, and BMI. All participants signed written consents. The study was approved by the Zambia National Health Research Authority.
Results
The median age (interquartile range) for PWH and HIV negative group were 52 (46-63) vs 46 (29-59) years, respectively (p<0.001). Females were preponderant in each group (32/50 PWH vs 50/82 HIV-negative). Hypertension was present in 28% (n=14/50) of PWH and 22% (18/82) among the HIV-negative. The factors associated with hypertension in the HIV-negative group after adjusting for age, sex, and BMI included development of heart palpitations following a salty meal ( AOR 4.53, 95% CI 1.10-2.18, p=0.047), preference for low salt (AOR 0.55, 95% CI 0.31-0.98, p=0.044), peripheral artery disease (AOR 5.90, 95% CI 0.39-8.95, p=0.003), left ventricular internal dimension at end -diastole (AOR 4.35, 95%CI 1.02-18.48, p=0.046), Framingham risk score (2008) (AOR 1.20, 95% CI 1.04-1.39, p=0.012), and atherosclerotic cardiovascular disease risk score (AOR 2.13, 95% CI 1.25-3.63, p=0.005). However, in PWH only waist circumference (AOR 1.16, 95%CI 1.03-1.32, p=0.015), SSBP (AOR 9.69 95%CI 1.84-51.00, p= 0.007), and Interventricular septum thickness at end -diastole (AOR 12, 95%CI 0.14-11.07, p=0.034) remained significantly associated with hypertension.
Conclusions
Hypertension is associated with CVD in both PWH and HIV negative. However, the CVD phenotype and risk are different and require further investigation.