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SA JOURNAL OF DIABETES & VASCULAR DISEASE
RESEARCH ARTICLE
VOLUME 16 NUMBER 1 • JULY 2019
37
While the association between lower CD4 count and
prevalence of hypertension was not certain, lower CD4 count
was indicative of a lower prevalence of hypertension among
those with low CD4 counts. There was no association between
hypertension and current ART regimen (Table 3). The median
duration on ART was not significantly different for those with or
without hypertension (Mann–Whitney test,
p
= 0.6794).
A total of 207 (14%) patients had an elevated non-fasting
total cholesterol level (> 5.2 mmol/l). On multivariate analysis,
being above 40 years of age [adjusted OR 1.95 (1.42–2.69),
p
= 0.001] and having an increased waist circumference [adjusted
OR 2.06 (1.14–3.71),
p
= 0.0164] were associated with having a
raised total cholesterol level. In addition, raised total cholesterol
was more likely in those on TDF [adjusted OR 2.20 (1.28–3.78),
p
= 0.0042], AZT [adjusted OR 2.50 (1.50–4.18),
p
= 0.004]
and D4T-containing regimens [adjusted OR 3.13 (1.72–5.71),
p
= 0.002]. However, the median duration on ART was not
significantly different for those with or without a raised total
cholesterol level (Mann–Whitney test,
p
= 0.1261). There was no
Table 1.
Prevalence of cardiovascular risk factors among people living
with HIV
Variables
Frequency (
n
)
Overall %
Age ≥ 40 years
716
47.4
Male gender
471
31.2
Current smokers
29
1.9
Increased waist circumference*
89
5.9
Total cholesterol ≥ 5.2 mmol/l
207
13.7
Body mass index ≥ 25 kg/m
2
182
12.1
Random blood glucose ≥ 7.8 mmol/l
31
2.1
Known diabetes at screening
7
0.5
Cardiovascular risk score ≥ 10%
8
0.5
Pre-hypertension
609
40.4
Hypertension stage 1
157
10.4
Hypertension stage 2
43
2.9
*Females ≥ 90 cm, males ≥ 100 cm.
Table 2.
Cardiovascular risk factors stratified by ART status
ART,
Pre-ART,
CVD risk factors
n
(%)
n
(%)
p
-value
OR (95% CI)
Male gender
396 (32.5) 74 (26.0) 0.0312 1.38 (1.03–1.84)
Age ≥ 40 years
629 (51.7) 87 (30.5) 0.0001 2.43 (1.85–3.21)
Current smokers
24 (2.0)
5 (1.8)
0.8100 1.13 (0.43–2.98)
Total cholesterol
≥ 5.2 mmol/l
186 (15.3) 19 (6.7) 0.0001 2.53 (1.55–4.13)
Body mass index
≥ 25 kg/m
2
151 (12.4) 31 (10.9) 0.4761 1.16 (0.77–1.75)
Elevated waist
circumference*
76 (6.2)
13 (4.6) 0.2786 1.39 (0.76–2.55)
Random blood
glucose ≥ 7.8 mmol/l
25 (2.1)
5 (1.8)
0.7447 1.17 (0.45–3.10)
Cardiovascular risk
score ≥ 10%
6 (0.5)
2 (0.7)
0.6630 0.70 (0.14–3.49)
Known diabetes
6 (0.5)
1 (0.4)
1.000 1.41 (0.17–11.70)
Hypertension
666 (54.7) 140 (49.3) 0.0985 1.24 (0.96–1.61)
Pre-hypertension
494 (47.3) 113 (44.0) 0.3415 1.14 (0.96–1.61)
Hypertension stage 1 132 (19.3) 24 (14.3) 0.1303 1.44 (0.90–2.30)
Hypertension stage 2 40 (6.6)
3 (2.0) 0.0291* 3.48 (1.06–11.42)
*Females ≥ 90 cm, males ≥ 100 cm; Fischer’s exact two-sided test.
Table 3.
Unadjusted and adjusted odds ratios for hypertension
Unadjusted
OR Adjusted OR
Characteristic
OR (95% CI)
p
-value
OR (95% CI)
p
-value
Male gender
1.65 (1.32–2.06) 0.0001
1.68 (1.32–2.14) 0.0001
Age ≥ 40 years
2.06 (1.67–2.53) 0.0001 1.78 (1.43–2.22) 0.0001
Current smokers 1.42 (0.67–3.02 0.3653
1.02 (0.47–2.24) 0.9574
Body mass index
≥ 30 kg/m
2
3.14 (1.35–7.31) 0.0079
1.47 (0.55–3.94) 0.4421
Random blood
glucose
≥ 7.8 mmol/l
1.13 (0.54–2.34) 0.7459
1.09 (0.51–2.33) 0.8225
Increased waist
circumference* 2.95 (1.79–4.87) 0.0001
2.49 (1.39–4.43) 0.0020
ART regimen
No ART
Ref
Ref
Ref
Ref
TDF-based
1.18 (0.88–1.58) 0.2794
1.10 (0.81–1.49) 0.5506
AZT-based
1.40 (1.07–1.84) 0.0152
1.26 (0.95–1.68) 0.1090
D4T-based
1.42 (0.97–2.06) 0.068
1.22 (0.82–1.81) 0.3226
LPV-based
0.91 (0.41–2.03) 0.8212
0.97 (0.42–2.25) 0.9385
CD4 count
(cells/mm
3
)
Missing
0.71 (0.53–0.94) 0.0165
0.72 (0.54–0.97) 0.0307
0–100
0.47 (0.23–0.92) 0.0287
0.49 (0.24–0.99) 0.0472
101–200
0.78 (0.47–1.29) 0.3369
0.67 (0.40–1.14) 0.1406
201–350
0.67 (0.50–0.91) 0.0112
0.59 (0.43–0.82) 0.0015
351–500
0.84 (0.62–1.12) 0.2315
0.77 (0.56–1.04) 0.0882
> 500
Ref
Ref
Ref
Ref
*Females ≥ 90 cm, males ≥ 100 cm.
CARVETREND 6,25, 12,5, 25 mg.
Each tablet contains 6,25, 12,5, 25 mg carvedilol respectively. S3
A37/7.1.3/0276, 0277, 0278. NAM NS2 08/7.1.3/0105, 0104, 0103. BOT S2 BOT1101790, 1791, 1792. For
full prescribing information, refer to the professional information approved by SAHPRA, December 2014.
1)
Panagiotis C Stafylas, Pantelis A Sarafidis. Carvedilol in hypertension treatment.
Vascular Health and Risk
Management
2008;4(1):23-30.
CDE479/07/2018.
CUSTOMER CARE LINE
0860 PHARMA (742 762) / +27 21 707 7000
www.pharmadynamics.co.zaC A R V E D I L O L
6,25 mg 12,5 mg 25 mg
CARVEDILOL:
• is indicated
twice daily
for
mild to moderate stable
symptomatic congestive
heart failure
• is indicated
once daily
for
essential mild to moderate
hypertension
•
has a positive effect
on metabolic parameters.
1
RESTORE
cardiac function
ß