Predictors of hypertension and changes of blood pressure in HIV-infected patients
Details
Serval ID
serval:BIB_2390CF9791BC
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Predictors of hypertension and changes of blood pressure in HIV-infected patients
Journal
Antiviral Therapy
ISSN
1359-6535 (Print)
Publication state
Published
Issued date
2005
Volume
10
Number
7
Pages
811-23
Notes
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Abstract
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.
Keywords
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
Pubmed
Web of science
Create date
29/01/2008 9:52
Last modification date
20/08/2019 14:01