Prevalence and Risk Factors of Hypertension among Patients with Opioid Use Disorder in Methadone Maintenance Treatment

Abstract

AbstractBACKGROUNDThe current prevalence of hypertension (HTN) and risk factors that characterize its occurrence during long-term methadone maintenance treatment (MMT) have not been established.METHODSHTN was defined if either systolic blood pressure (BP) ≥140 mmHg or diastolic BP ≥90 mmHg was detected twice (one week apart) among adult MMT patients. Recorded and current body mass index (BMI), BP, methadone dose and serum level, and drugs in urine were analyzed. Data on socioeconomic and addiction history characteristics were also retrieved.RESULTSHTN was detected in 103 (35.4%) of the 291 study patients (age range 26-81 years, 62 females). The HTN and non-HTN groups were comparable in sex (P=0.3), age (56.6±9.6 vs. 55.3±9.7 years,P=0.3), and duration in MMT (13.0±9.1 vs. 12.5±8.6 years,P=0.7). Age correlated linearly with duration in MMT (R=0.3,P<0.001) and with systolic BP (R=0.27,P<0.001). Patients with HTN had higher BMI values than those without HTN (28.1±5.4 vs. 25.5±5.2, respectively,P<0.001) and fewer had positive urine test findings to any substance (35.7% vs. 50.5%,P=0.01). Comparison of first methadone serum, BP, and BMI levels 11.9±5.8 years earlier increased more for the HTN group, independent of methadone dose and serum levels that lowered significantly over time. Drug abuse and older age were not associated with increased BMI and BP.CONCLUSIONWeight gain was associated with BP elevation and characterized patients who succeeded in drug abstinence during MMT.PERSPECTIVESIdentifying HTN and offering treatment for this highly prevalent life-threatening condition among older patients in MMT is recommended.