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Hypertension and Cardiovascular Disease Risk Among Individuals With Versus Without HIV

Mohammed Siddiqui1, Lonnie Hannon2, Zhixin Wang3

  • 1Department of Medicine (M.S., S.O., S.L.H., E.T.O.), University of Alabama at Birmingham, Birmingham, AL.

Hypertension (Dallas, Tex. : 1979)
|January 25, 2023
PubMed

Insights

Hypertension increases cardiovascular disease (CVD) risk in people with and without HIV. The risk of acute myocardial infarction (AMI) is notably higher for individuals with HIV and hypertension.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Individuals with HIV often have hypertension, leading to a high incidence of cardiovascular disease (CVD).
  • Understanding the differential impact of hypertension on CVD risk in HIV-positive populations is crucial for targeted interventions.

Purpose of the Study:

  • To investigate whether the association between hypertension and CVD risk differs between individuals with and without HIV.
  • To compare the incidence of acute myocardial infarction (AMI), stroke, and heart failure in relation to hypertension in these two groups.

Main Methods:

  • Analysis of a large cohort of US adults with (108,980) and without (435,920) HIV from 2011-2019 using the Marketscan database.
  • Matched analysis with a 1:4 ratio, focusing on incident CVD events (AMI, stroke, heart failure) identified via validated claims-based algorithms.
  • Multivariable adjustment and interaction analysis to assess the effect of hypertension on CVD risk stratified by HIV status.

Main Results:

  • Hypertension was associated with increased CVD risk in both HIV-positive and HIV-negative individuals.
  • A significantly stronger association between hypertension and AMI was observed in individuals with HIV (HR 1.70) compared to those without (HR 1.35).
  • No significant effect modification by HIV status was found for the association of hypertension with stroke or heart failure.

Conclusions:

  • Hypertension is linked to elevated risks of CVD, AMI, stroke, and heart failure in both HIV-positive and HIV-negative individuals.
  • The study highlights a particularly amplified risk of AMI associated with hypertension among individuals living with HIV.
  • Emphasizes the critical need to manage hypertension effectively in the HIV-positive population due to their heightened CVD risk.
Abstract

Keywords:
cardiovascular diseasesheart failurehypertensionmyocardial infarctionstroke

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