TY - JOUR

T1 - Tropical diseases and risk of hypertension in the Amazon Basin

T2 - a cross-sectional study

AU - Holm, Anna Engell

AU - Gomes, Laura Cordeiro

AU - Lima, Karine O.

AU - Wegener, Alma

AU - Matos, Luan O.

AU - Vieira, Isabelle V. M.

AU - Kaagaard, Molly D.

AU - Pareek, Manan

AU - de Souza, Rodrigo Medeiros

AU - Farias Marinho, Claudio Romero

AU - Biering-Sorensen, Tor

AU - Silvestre, Odilson M.

AU - Brainin, Philip

PY - 2022

Y1 - 2022

N2 - Although infectious diseases have been associated with cardiovascular conditions, little is known about tropical disease burden and hypertension. We hypothesized that a history of tropical infections was associated with hypertension. We examined participants from outpatient clinics in the Amazon Basin who were interviewed about prior exposure to tropical diseases, including dengue, malaria hospitalization, and leishmaniasis. Hypertension was defined as a prior physician diagnosis of hypertension, treatment with anti-hypertensive medication, or a systolic blood pressure >= 140 mmHg and/or a diastolic blood pressure >= 90 mmHg. We used logistic regression models to examine the relationship between tropical infectious disease and hypertension. We included 556 participants (mean age 41 +/- 15 years, 61% women) of whom 214 (38%) had hypertension and 354 (64%) had a history of tropical infectious disease. The distribution of tropical diseases was: dengue 270 (76%), malaria hospitalization 104 (29%) and leishmaniasis 48 (14%). Any prior tropical infection was significantly associated with prevalent hypertension (odds ratio 1.76 [95% CI 1.22-2.54], P = 0.003) and the association remained significant after adjusting for age, sex, body mass index, diabetes, hypercholesterolemia, socioeconomic status, smoking, vegetable intake and serum creatinine. Persons with a history of >= 2 tropical infections (n = 64) had the greatest risk of hypertension (odds ratio 2.04 [95% CI 1.15-3.63], P = 0.015). In adjusted models, prior infection with dengue was associated with hypertension (P = 0.006), but no associations were found with malaria hospitalization (P = 0.39) or leishmaniasis (P = 0.98). In conclusion, a history of tropical infectious disease was associated with hypertension. This finding supports the idea that pathogen burden may be related to cardiovascular conditions.

AB - Although infectious diseases have been associated with cardiovascular conditions, little is known about tropical disease burden and hypertension. We hypothesized that a history of tropical infections was associated with hypertension. We examined participants from outpatient clinics in the Amazon Basin who were interviewed about prior exposure to tropical diseases, including dengue, malaria hospitalization, and leishmaniasis. Hypertension was defined as a prior physician diagnosis of hypertension, treatment with anti-hypertensive medication, or a systolic blood pressure >= 140 mmHg and/or a diastolic blood pressure >= 90 mmHg. We used logistic regression models to examine the relationship between tropical infectious disease and hypertension. We included 556 participants (mean age 41 +/- 15 years, 61% women) of whom 214 (38%) had hypertension and 354 (64%) had a history of tropical infectious disease. The distribution of tropical diseases was: dengue 270 (76%), malaria hospitalization 104 (29%) and leishmaniasis 48 (14%). Any prior tropical infection was significantly associated with prevalent hypertension (odds ratio 1.76 [95% CI 1.22-2.54], P = 0.003) and the association remained significant after adjusting for age, sex, body mass index, diabetes, hypercholesterolemia, socioeconomic status, smoking, vegetable intake and serum creatinine. Persons with a history of >= 2 tropical infections (n = 64) had the greatest risk of hypertension (odds ratio 2.04 [95% CI 1.15-3.63], P = 0.015). In adjusted models, prior infection with dengue was associated with hypertension (P = 0.006), but no associations were found with malaria hospitalization (P = 0.39) or leishmaniasis (P = 0.98). In conclusion, a history of tropical infectious disease was associated with hypertension. This finding supports the idea that pathogen burden may be related to cardiovascular conditions.

KW - PATHOGEN BURDEN

KW - CUTANEOUS LEISHMANIASIS

KW - INFECTIOUS BURDEN

KW - BLOOD-PRESSURE

KW - PROTECTION

KW - CYTOKINES

KW - MALARIA

KW - TRENDS

U2 - 10.1038/s41371-021-00633-1

DO - 10.1038/s41371-021-00633-1

M3 - Journal article

C2 - 34775497

VL - 36

SP - 1121

EP - 1127

JO - Journal of Human Hypertension

JF - Journal of Human Hypertension

SN - 0950-9240

ER -