Associação e fatores de risco para a hipertensão arterial sistêmica em pessoa vivendo com HIV, em comparação com população não infectada pelo HIV: uma revisão sistemática com meta-análise
Notice bibliographique
Résumé
Introduction Research on the prevalence of hypertension among People living with HIV/AIDS (PLWHA) has yielded conflicting results. The association and risk factors for this condition, when comparing PLWHA to non-infected individuals, remain inconclusive and may be related to traditional risk factors or HIV-specific characteristics. Objective: To evaluate the association and risk factors for hypertension in PLWHA compared to non-infected individuals. Methods: A systematic review with meta-analysis of observational studies (cross-sectional, cohort, and case-control) was conducted. Searches were performed in four databases (PubMed, Embase, Web of Science, and Global Index Medicus), supplemented by manual searches of reference lists from included studies. Retrieved results were imported into the Covidence® software, where duplicates were removed, and study selection and data extraction were conducted. Eligible participants were those aged ≥18 years with a medical diagnosis of hypertension, self-reported hypertension diagnosis, use of antihypertensive medication, or studies using electronic health records to classify participants with hypertension. Studies conducted with children and adolescents under 18 years old, pregnant women, non-systemic hypertension, and other study designs were excluded. The methodological quality of the included articles was assessed using the Newcastle-Ottawa Scale for cohort and case-control studies and the Joanna Briggs Institute Checklist for Analytical Cross-Sectional Studies for cross-sectional studies. Outcomes evaluated included systolic and diastolic blood pressure by HIV status, the association between HIV status and hypertension, and risk factors for hypertension. Continuous outcome data were summarized using the mean difference (MD) as the effect measure, based on a random-effects model. Binary outcomes were analyzed using the relative risk (RR) and 95% confidence interval (CI). Heterogeneity was quantified using Cochran's Q test and Higgins' I² test. Publication bias was assessed through funnel plots and Egger’s statistical test. Results: 24 studies were included, though only cross-sectional studies (n = 21) were analyzed in the meta-analysis. Five studies were of low methodological quality, nine of moderate quality, and ten of high quality. PLWHA had a 9% lower risk of hypertension compared to non-infected individuals, but this difference was not statistically significant (RR 0.91, 95% CI: 0.76–1.09). Considerable heterogeneity was observed (I² = 98.4%), and the funnel plot revealed an asymmetric distribution, confirmed by Egger’s test. PLWHA tended to have significantly lower systolic blood pressure than non-infected individuals (MD: -3.67, 95% CI: -6.70; -0.64). Regarding diastolic blood pressure, although PLWHA showed lower values than non-infected individuals, the difference was not statistically significant (MD: -0.21, 95% CI: -2.38–1.96). Additionally, women (RR 0.46, 95% CI: 0.27–0.79) and overweight HIV-infected participants (RR 0.74, 95% CI: 0.56–0.98) had a significantly lower risk of hypertension compared to non-infected individuals. Conclusion: The results showed that PLWHA had lower mean differences in systolic and diastolic blood pressure and risk in the association between HIV status and hypertension. However, interpretations require caution due to the low to moderate methodological quality and high heterogeneity.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,019 | 0,050 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,013 | 0,032 |
| Bibliométrie | 0,008 | 0,008 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,005 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».