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

BACKGROUND The current prevalence of hypertension (HTN) and risk factors that characterize its occurrence during long-term methadone maintenance treatment (MMT) have not been established. METHODS HTN 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. RESULTS HTN 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. CONCLUSION Weight gain was associated with BP elevation and characterized patients who succeeded in drug abstinence during MMT. PERSPECTIVES Identifying HTN and offering treatment for this highly prevalent life-threatening condition among older patients in MMT is recommended. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Adelson Family Foundation ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study was approved by the Helsinki Committee (IRB) of the Tel Aviv Sourasky Medical Center. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes no