Disparities in Hypertension Prevalence, Awareness, Treatment, and Control Among Women Living With and Without HIV in the US South

Jessica Blair; Mirjam-Colette Kempf; Jodie A Dionne; Zenoria Causey-Pruitt; Jenni M Wise; Elizabeth A Jackson; Paul Muntner; David B Hanna; Jorge R Kizer; Margaret A Fischl; Igho Ofotokun; Adaora A Adimora; Stephen J Gange; Ilene K Brill; Emily B Levitan

doi:10.1093/ofid/ofad642

Disparities in Hypertension Prevalence, Awareness, Treatment, and Control Among Women Living With and Without HIV in the US South

Open Forum Infect Dis. 2023 Dec 18;11(1):ofad642. doi: 10.1093/ofid/ofad642. eCollection 2024 Jan.

Authors

Affiliations

¹ Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
² Schools of Nursing, Public Health, and Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
³ Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
⁴ School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA.
⁵ Division of Cardiovascular Disease, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
⁶ Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NewYork, USA.
⁷ Cardiology Section, SanFrancisco Veterans Health Care System, and Departments of Medicine, Epidemiology, and Biostatistics, University of California San Francisco, San Francisco, California, USA.
⁸ Division of Infectious Diseases, Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida, USA.
⁹ Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, Georgia, USA.
¹⁰ Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
¹¹ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

Abstract

Background: Hypertension-related diseases are major causes of morbidity among women living with HIV. We evaluated cross-sectional associations of race/ethnicity and HIV infection with hypertension prevalence, awareness, treatment, and control.

Methods: Among women recruited into Southern sites of the Women's Interagency HIV Study (2013-2015), hypertension was defined as (1) systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg according to clinical guidelines when data were collected, (2) self-report of hypertension, or (3) use of antihypertensive medication. Awareness was defined as self-report of hypertension, and treatment was self-report of any antihypertensive medication use. Blood pressure control was defined as <140/90 mm Hg at baseline. Prevalence ratios for each hypertension outcome were estimated through Poisson regression models with robust variance estimators adjusted for sociodemographic, behavioral, and clinical risk factors.

Results: Among 712 women, 56% had hypertension and 83% were aware of their diagnosis. Of those aware, 83% were using antihypertensive medication, and 63% of those treated had controlled hypertension. In adjusted analyses, non-Hispanic White and Hispanic women had 31% and 48% lower prevalence of hypertension than non-Hispanic Black women, respectively. Women living with HIV who had hypertension were 19% (P = .04) more likely to be taking antihypertension medication when compared with women living without HIV.

Conclusions: In this study population of women living with and without HIV in the US South, the prevalence of hypertension was lowest among Hispanic women and highest among non-Hispanic Black women. Despite similar hypertension prevalence, women living with HIV were more likely to be taking antihypertensive medication when compared with women living without HIV.

Keywords: HIV; antihypertensive agents; hypertension; racial and ethnic minorities; women.

Abstract

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