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Browsing by Author "Furrer H"

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    Awareness and management of elevated blood pressure among human immunodeficiency virus-infected adults receiving antiretroviral therapy in urban Zambia: a call to action.
    (2017) Bauer S; Wa Mwanza M; Chilengi R; Holmes CB; Zyambo Z; Furrer H; Egger M; Wandeler G; Vinikoor MJ; a Department of Infectious Diseases , Bern University Hospital, University of Bern , Bern , Switzerland.; e Department of Medicine , University of Alabama at Birmingham , Birmingham , USA.; b Centre for Infectious Diseases Research in Zambia , Lusaka , Zambia.; f School of Medicine , University of Zambia , Lusaka , Zambia.; d Institute of Social and Preventive Medicine , University of Bern , Bern , Switzerland.; c School of Medicine , Johns Hopkins University , Baltimore , USA.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    The prevalence of high blood pressure (HBP) and hypertension (HTN), awareness of the diagnoses, and use of anti-hypertensive drugs were examined among human immunodeficiency virus (HIV)-infected individuals on antiretroviral therapy (ART) in Zambia's capital Lusaka. Within a prospective cohort based at two public sector ART clinics, BP was measured at ART initiation and every 6 months thereafter as a routine clinic procedure. Predictors of HBP (systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg) during one year on ART were analyzed using logistic regression, and the proportion with HTN (2+ episodes of HBP >3 months apart) described. A phone survey was used to understand patient awareness of HBP, use of anti-hypertensive drugs, and history of cardiovascular events (CVE; myocardial infarction or stroke). Among 896 cohort participants, 887 (99.0%) had at least one BP measurement, 98 (10.9%) had HBP, and 57 (6.4%) had HTN. Increasing age (10-year increase in age: adjusted odds ratio [AOR] = 1.50; 95% confidence interval [CI] 1.20-1.93), male sex (AOR = 2.33, 95% CI 1.43-3.80), and overweight/obesity (AOR = 4.07; 95% CI 1.94-8.53) were associated with HBP. Among 66 patients with HBP, 35 (53.0%) reported awareness of the condition, and nine (25.7%) of these reported having had a CVE. Only 14 (21.2%) of those reached reported ever taking an anti-hypertensive drug, and one (1.5%) was currently on treatment. These data suggest that major improvements are needed in the management of HBP among HIV-infected individuals in settings such as Zambia.

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