Variations in antihypertensive medication treatment and blood pressure control among Veterans with HIV and existing hypertension
Authors' conclusion
In a retrospective analysis of large VHA data, we found that VLWH with HTN have suboptimal antihypertensive medication prescription and BP control. Black VLWH had higher HTN medication prescription rates but lower optimal BP control.
Study context
- Population
- Veterans living with HIV and hypertension receiving Veterans Health Administration (VHA) care, January 2018 to December 2019mean age 61 years, 97% male
- Participants
- 17,468 veterans
- Exposure
- Antihypertensive prescription and blood pressure (BP) control by patient characteristics (eg, race) and across VHA facilities
- Outcome
- Antihypertensive medication prescription and optimal BP control (SBP <130 mmHg and DBP <80 mmHg)
Methodological details2-level hierarchical multivariate logistic regression
- 2-level hierarchical multivariate logistic regression
Main finding
As reported in the abstract
Black
- Antihypertensive prescription
- 75%
- Optimal BP control
- 24%
White
- Antihypertensive prescription
- 71%
- Optimal BP control
- 31%
Antihypertensive prescription
Black75%
White71%
Optimal BP control
Black24%
White31%
Black vs WhiteOdds ratio (95% CI)
Antihypertensive prescription, multivariate
1.32(1.22–1.42)
Optimal BP control, multivariate
0.82(0.76–0.88)
- Overall prescribed antihypertensive medication
- 73%
- Overall optimal BP control
- 27%
Observational data: associations, not effects.
Further findings
Antihypertensive prescription by comorbidity and HIV care
- History of CVD, DM or kidney disease
- >80%
- Receiving ART with controlled HIV viral load
- ∼75%
Inter-facility variation (median OR)
- Variability in antihypertensive prescription and BP control between VHA facilities for similar patients
- about 10%
- Greater inter-facility variation in prescription with history of HF and without ART
Positive correlates of prescription and optimal BP control
- Number of outpatient visits in prior year; histories of DM, CAD and HF
Original publication
Variations in antihypertensive medication treatment and blood pressure control among Veterans with HIV and existing hypertension. Am Heart J. Published 29 August 2024. doi:10.
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