Left ventricular remodelling in asymptomatic HIV infection on chronic HAART: comparison between hypertensive and normotensive subjects with and without HIV infection

• Published in: Journal of human hypertension Vol. 26; no. 10; pp. 570 - 576
• Main Authors: Grandi, A M, Nicolini, E, Giola, M, Gianni, M, Maresca, A M, Marchesi, C, Guasti, L, Balsamo, M L, Venco, A, Grossi, P A
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-10-2012; Nature Publishing Group
• Subjects: 631/443/592/1540; 692/699/255/1901; 692/699/75/243; 692/700/565/1436; Antiretroviral drugs; Antiretroviral Therapy, Highly Active; Arterial hypertension. Arterial hypotension; Asymptomatic; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Body mass index; Cardiology. Vascular system; Cardiovascular diseases; Care and treatment; Case-Control Studies; Cholesterol; Chronic infection; Drug therapy; Echocardiography; Epidemiology; Experimental diseases; Fasting; Female; Glucose; Health Administration; Health aspects; Heart; Highly active antiretroviral therapy; HIV; HIV infection; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - physiopathology; Human immunodeficiency virus; Humans; Hypertension; Hypertension - complications; Hypertension - diagnostic imaging; Hypertrophy; Infections; Male; Medical sciences; Medicine & Public Health; Metabolic disorders; Metabolic Syndrome; original-article; Public Health; Risk factors; Smoking; Triglycerides; Ventricle; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Function, Left - physiology; Ventricular Remodeling; Italy; metabolic syndrome; highly active antiretroviral therapy; left ventricular hypertrophy; diastolic function; HIV infection; Human; Hypertension; Cardiovascular disease; Asymptomatic; Left ventricle; Infection; Treatment; Comparative study
• ISSN: 0950-9240; 1476-5527
• DOI: 10.1038/jhh.2011.81

The high cardiovascular risk of HIV infected (HIV+) patients is still partly unexplained. We aimed to evaluate if HIV infection and highly active antiretroviral therapy (HAART) are linked
per se
to left ventricular (LV) remodelling, independently of blood pressure (BP) values. We enrolled 4 groups of patients matched by gender, age, body mass index and smoking habit: 30 HIV+ hypertensives, 30 HIV+ normotensives, 30 not-infected (HIV−) hypertensives and 30 HIV− normotensives. HIV+ patients were on chronic HAART. Hypertension was newly diagnosed (⩽6 months) and never treated. Each patient underwent blood tests, 24-h BP monitoring and LV echocardiogram. The 4 groups had similar fasting glucose and cholesterol; triglycerides, HOMA index and prevalence of metabolic syndrome were higher in the HIV+ groups. Despite similar 24-h BP values, HIV+ hypertensives had greater LV mass and higher prevalence of preclinical diastolic dysfunction than HIV− hypertensives. Compared to HIV− normotensives, HIV+ normotensives had similar 24-h BP values, but greater LV mass and lower LV diastolic indices, similar to HIV− hypertensives, whose 24-h BP values were higher. Asymptomatic HIV infection and chronic HAART are associated with myocardial hypertrophy and preclinical diastolic dysfunction, independently of BP values.