Table 3. Characteristics associated with blood pressure control among 699 HIV-infected patients on antihypertensive medication attending the UAB 1917 HIV Clinic in 2013.
| Characteristic | BP controlled | BP not controlled | Univariate analysis | Multivariable analysisc | ||
|---|---|---|---|---|---|---|
| (n = 380) | (n = 319) | |||||
| n (%)a or | n (%)a or | Prevalence ratio | p-value | Prevalence ratio | p-value | |
| median (IQR)b | median (IQR)b | (95%CI) | (95%CI) | |||
| Age, years | ||||||
| <40 | 35 (47.3) | 39 (52.7) | 1.00 | - | 1.00 | - |
| 40–59 | 278 (55.8) | 220 (44.2) | 1.18 (0.92–1.52) | 0.20 | 1.12 (0.87–1.44) | 0.39 |
| ≥60 | 67 (52.8) | 60 (47.2) | 1.12 (0.83–1.49) | 0.46 | 1.07 (0.79–1.46) | 0.65 |
| Sex | ||||||
| Female | 104 (56.5) | 80 (43.5) | 1.00 | - | 1.00 | - |
| Male | 276 (53.6) | 239 (46.4) | 0.95 (0.82–1.10) | 0.49 | 0.87 (0.73–1.02) | 0.09 |
| Race | ||||||
| White | 183 (60.2) | 121 (39.8) | 1.00 | - | 1.00 | - |
| African American | 197 (49.9) | 198 (50.1) | 0.83 (0.72–0.95) | 0.006 | 0.80 (0.69–0.93) | 0.004 |
| HIV transmission risk factor | ||||||
| Heterosexual | 141 (50.9) | 136 (49.1) | 1.00 | - | - | - |
| MSM | 205 (58.4) | 146 (41.6) | 1.15 (0.99–1.33) | 0.06 | - | - |
| IVDU | 31 (50.8) | 30 (49.2) | 1.00 (0.76–1.31) | 0.99 | - | - |
| Insurance status | ||||||
| Private | 163 (53.4) | 142 (46.6) | 1.00 | - | - | - |
| Public | 143 (56.3) | 111 (43.7) | 1.05 (0.91–1.22) | 0.50 | - | - |
| None | 74 (52.9) | 66 (47.1) | 0.99 (0.82–1.19) | 0.91 | - | - |
| BMI, kg/m2 | ||||||
| Normal/Underweight (<25) | 118 (55.9) | 93 (44.1) | 1.00 | - | 1.00 | - |
| Overweight (25–29.9) | 129 (55.4) | 104 (44.6) | 0.99 (0.84–1.17) | 0.91 | 1.03 (0.88–1.22 | 0.69 |
| Obese (≥30) | 133 (52.2) | 122 (47.8) | 0.93 (0.79–1.10) | 0.42 | 0.97 (0.81–1.16) | 0.70 |
| Chronic kidney disease | ||||||
| No | 314 (54.8) | 259 (45.2) | 1.00 | - | 1.00 | - |
| Yes | 64 (52.5) | 58 (47.5) | 0.95 (0.80–1.15) | 0.64 | 0.99 (0.82–1.20) | 0.89 |
| Diabetes mellitus | ||||||
| No | 317 (54.5) | 265 (45.5) | 1.00 | - | 1.00 | - |
| Yes | 63 (53.9) | 54 (46.1) | 0.99 (0.82–1.19) | 0.88 | 0.94 (0.78–1.14) | 0.54 |
| History of CVD | ||||||
| No | 331 (53.9) | 283 (46.1) | 1.00 | - | - | - |
| Yes | 49 (57.7) | 36 (42.3) | 1.07 (0.88–1.30) | 0.50 | - | - |
| Duration of ART, years | 8.3 (4.3–12.9) | 8.5 (4.3–13.2) | 1.00 (0.94–1.06)d | 0.96 | - | - |
| CD4 count, cells/μL | ||||||
| ≥200 | 355 (54.0) | 302 (46.0) | 1.00 | - | - | - |
| <200 | 24 (60.0) | 16 (40.0) | 1.11 (0.85–1.44) | 0.43 | - | - |
| HIV viral load, copies/mL | ||||||
| ≥200 | 32 (55.2) | 26 (44.8) | 1.00 | - | - | - |
| <200 | 346 (54.3) | 291 (45.7) | 0.98 (0.77–1.25) | 0.90 | - | - |
| Time in care at HIV clinic, years | 8.7 (4.3–13.7) | 8.2 (4.5–13.5) | 1.00 (0.99–1.02)d | 0.87 | - | - |
| Cumulative visits in last 12 months | 3 (2–4) | 3 (2–4) | 0.99 (0.94–1.05)d | 0.75 | - | - |
| Adherent to ART | ||||||
| No | 51 (52.6) | 46 (47.4) | 1.00 | - | - | - |
| Yes | 211 (53.7) | 182 (46.3) | 1.01 (0.83–1.26) | 0.85 | - | - |
| Missing | 118 (56.5) | 91 (43.5) | 1.07 (0.86–1.34) | 0.53 | - | - |
| Current smoking | ||||||
| No | 203 (54.1) | 172 (45.9) | 1.00 | - | 1.00 | - |
| Yes | 77 (52.7) | 69 (47.3) | 0.97 (0.81–1.17) | 0.78 | 1.01 (0.86–1.18) | 0.93 |
| Missing | 100 (56.2) | 78 (43.8) | 1.04 (0.89–1.22) | 0.65 | 1.03 (0.80–1.31) | 0.84 |
| At risk alcohol use | ||||||
| No | 233 (55.2) | 189 (44.8) | 1.00 | - | 1.00 | - |
| Yes | 46 (50.0) | 46 (50.0) | 0.91 (0.73–1.13) | 0.38 | 0.88 (0.70–1.10) | 0.26 |
| Missing | 101 (55.6) | 84 (45.4) | 0.99 (0.85–1.16) | 0.89 | 0.97 (0.80–1.16) | 0.72 |
| Current substance abuse | ||||||
| No | 255 (52.8) | 228 (47.2) | 1.00 | - | - | - |
| Yes | 14 (60.9) | 9 (39.1) | 1.15 (0.82–1.62) | 0.41 | - | - |
| Missing | 111 (57.5) | 82 (42.5) | 1.09 (0.94–1.26) | 0.26 | - | - |
| Current depression | ||||||
| No | 243 (54.1) | 206 (45.9) | 1.00 | - | - | - |
| Yes | 45 (52.9) | 40 (47.1) | 0.98 (0.79–1.22) | 0.84 | - | - |
| Missing | 92 (55.8) | 73 (44.2) | 1.03 (0.99–1.21) | 0.72 | - | - |
| Duration of anti-hypertensive medication use | ||||||
| <1 year | 13 (37.1) | 22 (62.9) | 1.00 | 1.00 | ||
| 1 - <5 years | 168 (54.7) | 139 (45.3) | 1.47 (0.94–2.29) | 0.09 | 1.55 (0.97–2.47) | 0.07 |
| ≥5 years | 199 (52.4) | 158 (44.3) | 1.50 (0.97–2.33) | 0.07 | 1.60 (1.00–2.56) | 0.05 |
| Regimen intensity (number of antihypertensive drug classes) | ||||||
| One class | 151 (53.5) | 131 (46.5) | 1.00 | - | 1.00 | - |
| Two classes | 147 (58.1) | 106 (41.9) | 1.09 (0.93–1.26) | 0.29 | 1.08 (0.93–1.26) | 0.31 |
| Three or more classes | 82 (50.0) | 82 (50.0) | 0.93 (0.77–1.13) | 0.47 | 0.98 (0.80–1.20) | 0.87 |
| Regimen frequency | ||||||
| Once daily | 262 (56.5) | 202 (43.5) | 1.00 | - | 1.00 | - |
| More than once daily | 118 (50.2) | 117 (49.8) | 0.89 (0.77–1.03) | 0.13 | 0.88 (0.75–1.03) | 0.12 |
aRow percents
bMedian with first and third quartiles
cThe multivariable model included clinically relevant variables selected a priori (age, sex, race ethnicity, BMI, chronic kidney disease, diabetes mellitus, smoking, alcohol abuse, antihypertensive medication duration, regimen intensity and frequency). We allowed for selection of additional variables based on a moderate statistical association with BP control in univariate analysis, but none qualified.
dPer each 5 year increase in ART duration, 1 year increase in time under care at the clinic, and 1 visit increase in visit frequency.
Abbreviations: ART, antiretroviral therapy; BMI, body mass index; CI, confidence interval; CVD, cardiovascular disease; HIV, human immunodeficiency virus; IQR, interquartile range; IVDU, intravenous drug use; MSM, men who have sex with men; PR, prevalence ratio (log binomial regression); UAB, University of Alabama at Birmingham
Missing data: HIV transmission risk factor, 30 (plus 1 patient excluded for risk factor of hemophilia/blood transfusion); chronic kidney disease, 11; CD4 cell count, 7; VL, 10.