Hypertension in an urban HIV-positive population compared with the general population: influence of combination antiretroviral therapy

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Abstract
Hypertension is a major risk factor for cardiovascular diseases and mortality. The introduction of combination antiretroviral therapy for HIV-infected patients has changed their prognosis substantially, but there is an additional cost from the increased risk of cardiovascular diseases. We aimed to assess the prevalence of hypertension in an HIV-infected population and to identify possible predictors. A cohort of 542 unselected HIV-infected individuals had their blood pressure measured at three consecutive clinical visits. They were compared with an age-matched, sex-matched and body mass index-matched population-based control group (n=24 968). The prevalence of hypertension among the white HIV-infected individuals was 36.5%, which was not significantly different from the general population. The mean diastolic blood pressure was higher in HIV-infected individuals. The highest prevalence of hypertension was found in those who had been treated by combination antiretroviral therapy for more than 5 years (44.4%). Patients with hypertension were characterized by older age, male sex, white ethnicity, higher body mass index, total cholesterol and low-density lipoprotein cholesterol, lower glomerular filtration rate, more frequent microalbuminuria, longer time with known HIV-positive status and longer combination antiretroviral therapy duration compared with normotensive individuals. Multivariate analysis revealed age, sex, body mass index, cholesterol, combination antiretroviral therapy duration and microalbuminuria as independent predictors of hypertension. Diastolic blood pressure was increased in these white HIV-infected patients compared with the general population, but there was no difference in the prevalence of hypertension. However, the duration of combination antiretroviral therapy predicted hypertension independently.

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