Prevalence of Hypertension in HIV-Positive Patients on Highly Active Retroviral Therapy (HAART) Compared with HAART-Naïve and HIV-Negative Controls: Results from a Norwegian Study of 721 Patients
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Highly active antiretroviral therapy (HAART) may induce dyslipidemia, insulin resistance and body fat distribution similar to that seen in the metabolic syndrome. Hypertension is often a part of the classic metabolic syndrome, but few studies are published about hypertension in HIV-positive patients on HAART. The aim of this study was to compare the prevalence of hypertension in HIV-positive patients on HAART with that in HIV-positive/HAART-naïve patients and HIV-negative controls. The cross-sectional study included 283 unselected HIV-positive ambulatory patients, 219 who were on HAART and 64 who were HAART-naïve. Age- and gender-matched controls (n=438) were randomly selected from a simultaneous health survey of the general population. The prevalence of hypertension was 21% in patients on HAART, 13% in HAART-naïve patients (P=0.20), and 24% in HIV-negative controls (P=0.28). Among several possible risk factors for hypertension, only body mass index (BMI) was found to be a confounder. BMI was similar in HAART-treated and HAART-naïve patients but elevated in controls compared to HAART-treated patients. After adjustment for BMI, the prevalence of hypertension in HIV-negative controls was slightly lower than that in patients on HAART (P=0.29). The results demonstrated a prevalence of hypertension in patients on HAART similar to that in HIV-negative controls. The prevalence of hypertension was somewhat higher in patients on HAART compared to HAART-naïve patients, but the difference was not statistically significant. Considering the marked drop in mortality following antiretroviral therapy, we conclude that the possible influence of HAART on the prevalence of hypertension appears to be a minor problem.
KeywordsIndinavir Nelfinavir Lipodystrophy Autonomic Nervous Dysfunction Lower Blood Pressure Level
The authors wish to thank Anne Johanne Søgaard for valuable comments of the manuscript.
- 4.World Health Organisation (1999) Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: Diagnosis and classification of diabetes mellitus. Document no. WHO/NCD/NCS/99.2. WHO, Geneva, pp 31–32Google Scholar
- 5.Hauner H (2002) Insulin resistance and the metabolic syndrome: a challenge of the new millennium. Eur J Clin Nutr 56 [Suppl 1]:25–29Google Scholar
- 7.Henry K, Melroe H, Huebsch J, Hermundson J, Levine C, Swensen L, et al (1998) Severe premature coronary artery disease with protease inhibitors. Lancet 351:1328Google Scholar
- 9.Barbaro G, Di Lorenzo G, Giancaspro GPAM, Grisorio B (2002) Incidence of coronary artery disease in HIV-infected patients receiving or not protease inhibitors: a randomized, multicenter trial. In: Program and Abstracts of the XIV International AIDS Conference, abstract no. WeOrB-1307Google Scholar
- 11.Foster DW (1991) The lipodystrophies and other rare disorders of adipose tissue. In: Wilson JD, Braunwald E, Isselbacher KJ, Petersdorf RG, Martin JB, Fauci AS, Root RK (eds) Harrison’s principles of internal medicine, 12th edn. McGraw-Hill, New York, pp 1883–1887Google Scholar
- 12.Galindo Puerto MJ (2002) AHT and HIV – a new problem? Nutr Metab Disord HIV Infect 1:33–37Google Scholar
- 17.Grøntveit L (2002) Health profile for adults in Oslo. National Health Screening Service, OsloGoogle Scholar
- 20.Kramer MS (1991) Confounding bias. Clinical epidemiology and biostatistics, a primer for clinical investigators and decision-makers. Springer-Verlag, Berlin, p 53Google Scholar
- 30.McComsey GA, Yao LK, O’Riordan M, Lederman MM, Valdez H, Gripshover B, Rodriguez B, et al (2002) Lack of significant changes in blood pressure of HIV+ subjects, even after long-term use of PI therapy. In: Abstracts of the XIV International AIDS Conference, abstract no. B-10302Google Scholar
- 31.Chow D, Souza S, Richmond-Crum S, Shikuma C (2000) Epidemiological evidence of increasing blood pressure in HIV-1-infected individuals in the era of HAART. Antivir Ther 2000 5 [Suppl 5]:31–32Google Scholar