Predictors of hypertension and changes of blood pressure in HIV-infected patients


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Predictors of hypertension and changes of blood pressure in HIV-infected patients
Antiviral Therapy
Thiebaut  R., El-Sadr  W. M., Friis-Moller  N., Rickenbach  M., Reiss  P., Monforte  A. D., Morfeldt  L., Fontas  E., Kirk  O., De Wit  S., Calvo  G., Law  M. G., Dabis  F., Sabin  C. A., Lundgren  J. D.
1359-6535 (Print)
Statut éditorial
Date de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
OBJECTIVE: We assessed predictors of changes in systolic (SBP) and diastolic (DBP) blood pressure during follow-up and of the development of hypertension in HIV-infected individuals. METHODS: International cohort collaborative study (D:A:D) of established prospective cohorts of HIV-1-infected patients. Longitudinal analysis of changes in blood pressure (BP) was performed using mixed effects models in 17170 patients. Predictors of development of hypertension during follow-up (systolic BP > or =140 and/or diastolic BP > or =90 mmHg or initiation of antihypertensive treatment) were assessed using Cox models in 8 984 patients with a normal BP level at baseline. RESULTS: 73548 BP measurements with a median of 4 per patient (interquartile range [IQR]: 2-6) were recorded over a median follow-up of 2.3 years (IQR: 1.5-2.6). Risk factors significantly associated with a development of higher systolic BP and diastolic BP (differences > or =5 mmHg and P-values <0.001) during follow-up were: older age, male sex, higher body mass index (BMI) and use of BP-lowering drugs. In patients with normal BP at baseline, 1186 developed hypertension for an incidence of 72.1 per 1000 person-years (95% confidence interval: 68.2-76.0). Factors associated with development of hypertension were: male sex, higher BMI, older age, higher BP at baseline, high total cholesterol and clinical lipodystrophy. Cumulative duration of exposure to nucleoside reverse transcriptase inhibitors (P=0.75), protease inhibitors (P=0.92) as well as type of antiretroviral treatment at baseline (P=0.18) were not associated with a higher risk of hypertension. Cumulative duration of exposure to non-nucleoside reverse transcriptase inhibitors (NNRTIs) was significantly associated with lower risk of hypertension (hazard ratio=0.78 and 0.67 for those treated < or =10 months and >10 months compared with no exposure; P=0.005). CONCLUSIONS: Increased blood pressure in HIV-infected individuals is associated with established risk factors for hypertension. There was no evidence for an independent deleterious effect of any class of antiretroviral drugs on BP, although the use of NNRTIs was associated with a lower risk of development of hypertension.
Adult Aged Aged, 80 and over Anti-Retroviral Agents/adverse effects/therapeutic use Antiretroviral Therapy, Highly Active/adverse effects Blood Pressure/*physiology Cohort Studies Female HIV Infections/*complications/drug therapy/*physiopathology Humans Hypertension/*complications/drug therapy/*physiopathology Longitudinal Studies Male Middle Aged Risk Factors Sex Characteristics Time Factors
Web of science
Création de la notice
29/01/2008 9:52
Dernière modification de la notice
20/08/2019 14:01
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