RT Journal
A1 Butt AA, Justice AC, Freiberg MS
T1 RIsk of heart failure with human immunodeficiency virus is greater than hypertension?—reply
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2011
FD October 24
VO 171
IS 19
SP 1773
OP 1774
DO 10.1001/archinternmed.2011.560
UL http://dx.doi.org/10.1001/archinternmed.2011.560
AB 
We thank de Melo Neto et al for their insightful comments about our article.1 We agree that using ICD-9 codes can potentially introduce a bias in any analysis using such data. We have previously validated hypertension ICD-9 codes against structured medical chart review as the gold standard.2 Among HIV-infected persons enrolled in the 3-site Veterans Aging Cohort Study, the prevalence of hypertension by ICD-9 codes and medical chart reviews was 28% and 32% respectively, with an agreement of 85.2% and a κ value of 0.65. Hence, there may have been a slight underreporting of hypertension in the HIV-infected group. We are currently evaluating whether diagnosis of hypertension differs by HIV status using actual blood pressure measurement. For diabetes, we used a combination of laboratory measurements, use of insulin and oral hypoglycemic medications, and ICD-9 codes, as used in several previous studies.3- 4