The association between hepatitis C virus infection status and blood pressure in adults in the United States: NHANES 1999-2012

Abstract

Background: The Hepatitis C virus (HCV) infection is strongly associated with cardiovascular disease risk factors, but the relationship with blood pressure (BP) remains unclear.

Objectives: To assess the association between HCV infection status and BP in US adults.

Methods: Data for the study were obtained from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2012. The association of HCV infection status (including HCV infection, current HCV infection, and past HCV infection) with hypertension, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were explored using logistic or linear regression analyses respectively.

Results: A total of 25,850 participants (age≥18 years) were enrolled in the current study, including 14,162 participants with hypertension. After adjusting for all covariates, HCV infection/current HCV infection was not associated with hypertension and SBP compared to participants with non-HCV infection (OR: 1.34,95% CI 0.96-1.87/1.31 95% CI 0.91,1.91, β: -0.92, 95% CI -2.7-0.86/-0.35 95% CI -2.51,1.81, respectively). HCV infection/current HCV infection was only associated with elevated DBP (β: 4.1,95% CI 2.57-5.63/4.24,95% CI 2.27-6.21). However, there was no correlation with past HCV infection in participants with hypertension, SBP, and DBP compared to those with non-HCV infection (OR: 1.23,95% CI 0.59-2.54; β: -3.79, 95% CI -7.67-0.08 and 2.28 95% CI -0.36-4.92, respectively).

Conclusion: In a representative sample of US adults, it was found that both HCV infection and current HCV infection were independently linked to higher DBP. However, there was no association between past HCV infection and DBP.

Keywords: NHANES (National Health and Nutrition Examination Survey); diastolic blood pressure; hepatitis C virus; hypertension; systolic blood pressure.

Figure 1

Flow diagram of inclusion criteria and exclusion criteria. NHANES, National Health and Nutrition Examination Survey; HCV, hepatitis C virus; SBP, systolic blood pressure; DBP, diastolic blood pressure; BMI, body mass index; ASCVD, atherosclerotic cardiovascular disease; CKD, chronic kidney disease; AST, aspartate aminotransferase; ALT, alanine aminotransferase; HDL-C, high-density lipoprotein cholesterol.

Figure 2

Association between HCV infection and hypertension, systolic blood pressure, and diastolic blood pressure exposure in stratified analyses. The model was adjusted for age, sex, race/ethnicity, and education levels, marital, smoking status, alcohol drinker, hypoglycemic medications, antihypertensive medications, lipid-lowering medications, diabetes, stroke, ASCVD, CKD, hyperlipidemia, BMI, ALT, AST, albumin, bilirubin total, alkaline phosphatase, fast total cholesterol, HDL-C. NHANES, National Health and Nutrition Examination Survey; HCV, hepatitis C virus; SBP, systolic blood pressure; DBP, diastolic blood pressure; BMI, body mass index; ASCVD, atherosclerotic cardiovascular disease; CKD, chronic kidney disease; AST, aspartate aminotransferase; ALT, alanine aminotransferase; HDL-C, high-density lipoprotein cholesterol; OR, odds ratio; CI, confidence interval.