Effect of HIV duration on ambulatory blood pressure in HIV-infected individuals with high office blood pressure

Abstract

Objective. There is a scarcity of data on ambulatory blood pressure (ABP) in HIV-infected individuals. The aim of the study was to identify possible predictors of ABP in HIV-infected individuals. Methods. From a cohort of 542 HIV-infected patients, ABP monitoring was undertaken in 77 patients with high office blood pressure (BP) readings and without antihypertensive treatment. Results. 24-h and daytime ABPs were associated with HIV duration (r=0.24–0.33, p=0.004–0.033), but not with duration of combined antiretroviral therapy. In multivariate linear regression analyses with the different ABPs as dependent variables, HIV duration (unstandardized β=0.41–0.89, p=0.008–0.045) and log-transformed urinary albumin excretion (p=0.003–0.043) were predictors of all 24-h and daytime ABPs. Multiple logistic regression analysis revealed HIV duration (OR=1.14/year (95% CI 1.03–1.26)) as predictor of hypertension defined according to daytime ABP. Nocturnal hypertension was observed in 81%, white coat hypertension was present in 26%. Conclusions. HIV duration was an independent predictor of ABP and hypertension in a selected group of HIV-infected individuals. Nocturnal hypertension was prevalent, and white coat hypertension was present in one fourth of the patients.

Key Words::

• Ambulatory blood pressure
• combined antiretroviral therapy
• HIV-infections
• hypertension
• white coat hypertension

Acknowledgements

We acknowledge the skilled assistance of the nurses Astrid Marie Rudi, Kjersti Selnes, Lise Sørsvang, and Jorun Almark and biomedical laboratory scientist Heidi Bertheussen in the outpatient clinic at the Department of Infectious Diseases. We are indebted to Sigrun Elden for highly professional assistance with the ambulatory blood pressure measurements. We also acknowledge the work of Professor Emeritus Johan N. Bruun in establishing the HIV-cohort database. The study has been financed by Oslo University Hospital, Ullevål and by the HIV fund of the Department of Infectious Diseases at Oslo University Hospital, Ullevål. A grant has also been given from the Albert and Signe Bergmarken's Fund for Investigation of Kidney Diseases.

Presented in part at the 19th Scientific Meeting of the European Society of Hypertension, Milan, Italy, 12–16 June 2009 (Abstract 9A.5) and 26th Annual Meeting of the Scandinavian Society for Antimicrobiology and Chemotherapy, Tromsø, 3–6 September 2009 (Abstract P26).

Sources of support

Oslo University Hospital, Ullevål, Regional Health Committee, Norway. Signe and Albert Bergsmarken's Fund for Investigation of Kidney Diseases. Yngvar Såstad's Fund.

Declaration of interest: None