Hypertension Risk May Be Elevated in HIV Patients

HIV-positive patients carry a heavy burden.

Although today’s HIV treatments, which start as soon as the diagnosis is known if the patient is ready and willing to do so, extend life, but immunodeficiency and multidrug treatment remain concerns for infected individuals.

In addition, HIV-positive patients have a higher risk of cardiovascular disease, which may have something to do with their higher rates of hypertension. More generally, around 30% of the US population develops hypertension.

Recently, researchers conducted a study examining factors that may contribute to a higher prevalence of hypertension among patients with HIV-1. They structured their prospective, comparative cohort study to examine the prevalence and determinants of hypertension in patients with HIV-1.

This study, which was published ahead-of-print in the journal Clinical Infectious Diseases, enrolled 527 HIV-1-infected and 517 HIV-negative participants from an ongoing study. The researchers used a standard definition of hypertension (systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg) and the use of antihypertensive drugs to identify patients with hypertension.

Approximately 48% of HIV-positive participants had hypertension, compared with slightly more than one-third of the controls. Thus, the researchers determined that hypertension was more common among HIV-1-infected individuals.

Even after using logistic regression to adjust for age, sex, ethnicity, family history of hypertension, smoking, alcohol use, physical activity, and body mass index, the link between HIV and hypertension remained statistically significant. After adjusting for waist-to-hip ratio, however, the link was weaker. Notably, both measurements are associated with abdominal obesity and atrophy of subcutaneous fat.

Prior use of the antiretroviral stavudine also increased likelihood of problematic waist-to-hip ratio and hypertension. This led the researchers to suggest that changing body composition may contribute to hypertension in HIV-positive patients.

Stavudine can cause fat distribution changes (eg, lipoatrophy), and longer duration of therapy with stavudine was associated with greater risk of hypertension.

The participants who enrolled in this study were primarily patients with longstanding suppressed viremia and substantial CD4 cell recovery, and their average age was 52.7 years. Most patients were financially stable.