摘要
目的 对人类免疫缺陷病毒(human immunodeficiency virus,HIV)阳性者高血压的发病密度和影响因素进行系统综述,旨在探索HIV阳性者发生高血压的影响因素及潜在的机制.方法 通过中国知网、万方数据知识服务平台、PubMed、EMbase、Web of Science和Medline数据库系统检索HIV阳性者中高血压发病的相关文献,摘录基本信息、发病密度及影响因素.结果 最终纳入20篇研究,研究包含北美洲国家5篇,非洲国家5篇,亚洲国家4篇,欧洲国家2篇,多中心研究4篇.HIV阳性者的高血压发病密度为26.0/1 000人年~320.1/1 000人年.HIV阳性者新发高血压的影响因素包括传统因素如年龄、性别、种族、BMI和腹部肥胖、糖尿病、肾病和血脂异常;特异性的影响因素包括HIV感染时间、抗病毒治疗(antiretroviral therapy,ART)时长和ART药物等.结论 HIV阳性者的高血压发病密度较高,且地理差异较大.HIV阳性者新发高血压的传统影响因素作用比较确定,需要在HIV阳性者的生活方式中实施初级预防的策略和措施.然而,HIV和ART相关的影响因素对高血压发生的作用尚不清楚,需要进行前瞻性研究来确定HIV特异性因素的影响,以更好地了解HIV阳性者的高血压流行病学.
Abstract
Objective To systematically review the incidence density and influencing factors of hypertension in HIV positive people in order to explore the potential mechanisms of hypertension in HIV positive individuals.Methods We search literature related to incident hypertension among HIV-positive individuals through CNKI,Wanfang,PubMed,EMbase,Web of Science and Medline,databases and the basic information,incidence density and risk factors were extracted.Results A total of 20 studies were included,comprising 5 from North America,5 from Africa,4 from Asia,2 from Europe,and 4 from multicenter studies.The incidence density of hypertension in HIV-positive individuals ranged from 26.0 to 320.1 per 1 000 person-years.The risk factors of incident hypertension in HIV-positive individuals include traditional risk factors such as age,gender,race,BMI and abdominal obesity,diabetes,kidney disease,dyslipidemia,etc.HIV-specific factors included time of HIV infection,duration of antiviral therapy(ART),and antiviral drugs.Conclusions The incidence density of hypertension is relatively high among HIV-positive individuals,and the geographical variations are particularly pronounced.The contribution of traditional risk factors to incident hypertension among HIV-positive individuals is well established,underscoring the importance of implementing comprehensive strategies and interventions for primary prevention within this population's lifetstyles.However,the role of HIV and ART-related risk factors in hypertension remains unclear,and prospective studies are needed to better elucidate the epidemiology of hypertension in HIV-positive individuals.