Comorbidity-related treatment outcomes among HIV-Infected adults in the Bronx, NY

Carolyn Chu, Galina Umanski, Arthur Blank, Paul Meissner, Robert M. Grossberg, Peter A. Selwyn

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Aging, HIV infection, and antiretroviral therapy have been associated with increasing rates of chronic comorbidities in patients with HIV. Urban minority populations in particular are affected by both the HIV/AIDS and chronic disease epidemics. Our objectives were to estimate the prevalence of and risk factors for hypertension, dyslipidemia, and diabetes among HIV-infected adults in the Bronx and describe comorbidity-related treatment outcomes. This was a cross-sectional study of 854 HIV-positive adults receiving care at 11 clinics which provide HIV primary care services; clinics were affiliated with a large urban academic medical center. Data on blood pressure (BP), cholesterol, and glycemic control were collected through standardized chart review of outpatient medical records. We found prevalence rates of 26%, 48%, and 13% for hypertension, dyslipidemia, and diabetes, respectively. Older age, obesity, family history, and current protease inhibitor use were consistently associated with comorbidity. Diabetes treatment goals were achieved less often than BP and lipid goals, and concurrent diabetes was a significant predictor for BP and lipid control. In conclusion, major cardiovascular-related comorbidities are prevalent among HIVpositive adults in the Bronx, especially older and obese individuals. Differences exist in comorbidity-related treatment outcomes, especially for patients with concurrent diabetes. Because cardiovascular risk is modifiable, effective treatment of related comorbidities may improve morbidity and mortality in HIV-infected patients.

Original languageEnglish (US)
Pages (from-to)507-516
Number of pages10
JournalJournal of Urban Health
Volume88
Issue number3
DOIs
StatePublished - Jun 2011

Fingerprint

comorbidity
Comorbidity
chronic illness
HIV
hypertension
Dyslipidemias
Blood Pressure
Hypertension
Lipids
Urban Population
Protease Inhibitors
genealogy
cross-sectional study
morbidity
HIV Infections
Medical Records
Primary Health Care
Acquired Immunodeficiency Syndrome
AIDS
Chronic Disease

Keywords

  • Combination antiretroviral therapy
  • Comorbidities and HIV
  • Treatment outcomes and HIV

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Medicine(all)

Cite this

Comorbidity-related treatment outcomes among HIV-Infected adults in the Bronx, NY. / Chu, Carolyn; Umanski, Galina; Blank, Arthur; Meissner, Paul; Grossberg, Robert M.; Selwyn, Peter A.

In: Journal of Urban Health, Vol. 88, No. 3, 06.2011, p. 507-516.

Research output: Contribution to journalArticle

@article{ec34138d0b9648628219c9eb01cd299b,
title = "Comorbidity-related treatment outcomes among HIV-Infected adults in the Bronx, NY",
abstract = "Aging, HIV infection, and antiretroviral therapy have been associated with increasing rates of chronic comorbidities in patients with HIV. Urban minority populations in particular are affected by both the HIV/AIDS and chronic disease epidemics. Our objectives were to estimate the prevalence of and risk factors for hypertension, dyslipidemia, and diabetes among HIV-infected adults in the Bronx and describe comorbidity-related treatment outcomes. This was a cross-sectional study of 854 HIV-positive adults receiving care at 11 clinics which provide HIV primary care services; clinics were affiliated with a large urban academic medical center. Data on blood pressure (BP), cholesterol, and glycemic control were collected through standardized chart review of outpatient medical records. We found prevalence rates of 26{\%}, 48{\%}, and 13{\%} for hypertension, dyslipidemia, and diabetes, respectively. Older age, obesity, family history, and current protease inhibitor use were consistently associated with comorbidity. Diabetes treatment goals were achieved less often than BP and lipid goals, and concurrent diabetes was a significant predictor for BP and lipid control. In conclusion, major cardiovascular-related comorbidities are prevalent among HIVpositive adults in the Bronx, especially older and obese individuals. Differences exist in comorbidity-related treatment outcomes, especially for patients with concurrent diabetes. Because cardiovascular risk is modifiable, effective treatment of related comorbidities may improve morbidity and mortality in HIV-infected patients.",
keywords = "Combination antiretroviral therapy, Comorbidities and HIV, Treatment outcomes and HIV",
author = "Carolyn Chu and Galina Umanski and Arthur Blank and Paul Meissner and Grossberg, {Robert M.} and Selwyn, {Peter A.}",
year = "2011",
month = "6",
doi = "10.1007/s11524-010-9540-7",
language = "English (US)",
volume = "88",
pages = "507--516",
journal = "Journal of Urban Health",
issn = "1099-3460",
publisher = "Springer Science and Business Media Deutschland GmbH",
number = "3",

}

TY - JOUR

T1 - Comorbidity-related treatment outcomes among HIV-Infected adults in the Bronx, NY

AU - Chu, Carolyn

AU - Umanski, Galina

AU - Blank, Arthur

AU - Meissner, Paul

AU - Grossberg, Robert M.

AU - Selwyn, Peter A.

PY - 2011/6

Y1 - 2011/6

N2 - Aging, HIV infection, and antiretroviral therapy have been associated with increasing rates of chronic comorbidities in patients with HIV. Urban minority populations in particular are affected by both the HIV/AIDS and chronic disease epidemics. Our objectives were to estimate the prevalence of and risk factors for hypertension, dyslipidemia, and diabetes among HIV-infected adults in the Bronx and describe comorbidity-related treatment outcomes. This was a cross-sectional study of 854 HIV-positive adults receiving care at 11 clinics which provide HIV primary care services; clinics were affiliated with a large urban academic medical center. Data on blood pressure (BP), cholesterol, and glycemic control were collected through standardized chart review of outpatient medical records. We found prevalence rates of 26%, 48%, and 13% for hypertension, dyslipidemia, and diabetes, respectively. Older age, obesity, family history, and current protease inhibitor use were consistently associated with comorbidity. Diabetes treatment goals were achieved less often than BP and lipid goals, and concurrent diabetes was a significant predictor for BP and lipid control. In conclusion, major cardiovascular-related comorbidities are prevalent among HIVpositive adults in the Bronx, especially older and obese individuals. Differences exist in comorbidity-related treatment outcomes, especially for patients with concurrent diabetes. Because cardiovascular risk is modifiable, effective treatment of related comorbidities may improve morbidity and mortality in HIV-infected patients.

AB - Aging, HIV infection, and antiretroviral therapy have been associated with increasing rates of chronic comorbidities in patients with HIV. Urban minority populations in particular are affected by both the HIV/AIDS and chronic disease epidemics. Our objectives were to estimate the prevalence of and risk factors for hypertension, dyslipidemia, and diabetes among HIV-infected adults in the Bronx and describe comorbidity-related treatment outcomes. This was a cross-sectional study of 854 HIV-positive adults receiving care at 11 clinics which provide HIV primary care services; clinics were affiliated with a large urban academic medical center. Data on blood pressure (BP), cholesterol, and glycemic control were collected through standardized chart review of outpatient medical records. We found prevalence rates of 26%, 48%, and 13% for hypertension, dyslipidemia, and diabetes, respectively. Older age, obesity, family history, and current protease inhibitor use were consistently associated with comorbidity. Diabetes treatment goals were achieved less often than BP and lipid goals, and concurrent diabetes was a significant predictor for BP and lipid control. In conclusion, major cardiovascular-related comorbidities are prevalent among HIVpositive adults in the Bronx, especially older and obese individuals. Differences exist in comorbidity-related treatment outcomes, especially for patients with concurrent diabetes. Because cardiovascular risk is modifiable, effective treatment of related comorbidities may improve morbidity and mortality in HIV-infected patients.

KW - Combination antiretroviral therapy

KW - Comorbidities and HIV

KW - Treatment outcomes and HIV

UR - http://www.scopus.com/inward/record.url?scp=80052963403&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052963403&partnerID=8YFLogxK

U2 - 10.1007/s11524-010-9540-7

DO - 10.1007/s11524-010-9540-7

M3 - Article

C2 - 21302140

AN - SCOPUS:80052963403

VL - 88

SP - 507

EP - 516

JO - Journal of Urban Health

JF - Journal of Urban Health

SN - 1099-3460

IS - 3

ER -