Association between highly active antiretroviral therapy and hypertension in a large cohort of men followed from 1984 to 2003

• Published in: AIDS (London) Vol. 19; no. 9; pp. 953 - 960
• Main Authors: SEABERG, Eric C, MUNOZ, Alvaro, MING LU, DETELS, Roger, MARGOLICK, Joseph B, RIDDLER, Sharon A, WILLIAMS, Carolyn M, PHAIR, John P
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 10-06-2005
• Subjects: Adult; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiretroviral Therapy, Highly Active - adverse effects; Antiviral agents; Biological and medical sciences; Body Mass Index; Epidemiologic Methods; HIV Infections - drug therapy; HIV Infections - epidemiology; Human viral diseases; Humans; Hypertension - chemically induced; Hypertension - epidemiology; Infectious diseases; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Smoking - adverse effects; Tobacco, tobacco smoking; Toxicology; United States - epidemiology; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; United States; Systolic hypertension; Prognosis; Prevalence; isolated systolic hypertension; antiretroviral therapy; Tobacco smoking; Cardiovascular disease; Male; Epidemiology; Prevention; Body mass index; highly active antiretroviral therapy; Antiviral; Arterial pressure; Blood pressure; Human; Hypertension; Immunopathology; Drug combination; AIDS; Immune deficiency; Infection; Chemotherapy; Treatment; HIV; Viral disease; Combined treatment; Comparative study
• ISSN: 0269-9370; 1473-5571
• DOI: 10.1097/01.aids.0000171410.76607.f8

UO1-AI-35041: To examine the impact of HIV infection and highly active antiretroviral therapy on systolic and diastolic hypertension.
Cohort study with semi-annual assessment of the outcome.
We studied 5578 participants of the Multicenter AIDS Cohort Study with blood pressure measurements obtained between 1984 and 2003. The primary outcomes were systolic hypertension (SH; systolic blood pressure > 140 mmHg) and diastolic hypertension (DH; diastolic blood pressure > 90 mmHg). Statistical analyses were performed using multiple logistic regression with robust variance estimation.
Of the 84 813 person-visits available for analysis, 7.3 and 8.0% showed SH and DH, respectively. Controlling for age, race, body mass index, and smoking, HIV positive men not taking antiretroviral therapy were significantly less likely than HIV negative men to have SH [odds ratio (OR), 0.79; 95% confidence interval (CI), 0.70-0.89], as were men taking mono/combination therapy (OR, 0.69; 95% CI, 0.59-0.80). The prevalence of SH among men taking highly active antiretroviral therapy (HAART) for less than 2 years was similar to that among HIV negative men (OR, 1.06; 95% CI, 0.87-1.30), but was significantly higher thereafter; for 2 to 5 years of HAART (OR, 1.51; 95% CI, 1.25-1.82) and for more than 5 years of HAART (OR, 1.70; 95% CI, 1.34-2.16). In contrast, DH was not significantly higher among men with prolonged HAART use compared to that among HIV negative controls.
Prolonged HAART use was significantly associated with a higher prevalence of SH. This finding suggests that individuals taking HAART may be at increased risk of developing hypertension-related conditions and underscores the importance of blood pressure monitoring among these individuals.