Risk of Cardiovascular Events and Blood Pressure Control in Hypertensive HIV-Infected Patients: HIV Cohort Study (SHCS)

Nüesch, Reto; Wang, Qing; Elzi, Luigia; Bernasconi, Enos; Weber, Rainer; Cavassini, Matthias; Vernazza, Pietro; Thurnheer, Maria C.; Calmy, Alexandra; Battegay, Manuel; Bucher, Heiner C. (2013). Risk of Cardiovascular Events and Blood Pressure Control in Hypertensive HIV-Infected Patients: HIV Cohort Study (SHCS). JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES, 62(4), pp. 396-404. Lippincott Williams & Wilkins 10.1097/QAI.0b013e3182847cd0

[img] Text
Risk_of_Cardiovascular_Events_and_Blood_Pressure.5.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (203kB) | Request a copy

Background: Prevalence of hypertension in HIV infection is high, and information on blood pressure control in HIV-infected individuals is insufficient. We modeled blood pressure over time and the risk of cardiovascular events in hypertensive HIV-infected individuals. Methods: All patients from the Swiss HIV Cohort Study with confirmed hypertension (systolic or diastolic blood pressure above 139 or 89 mm Hg on 2 consecutive visits and presence of at least 1 additional cardiovascular risk factor) between April 1, 2000 and March 31, 2011 were included. Patients with previous cardiovascular events, already on antihypertensive drugs, and pregnant women were excluded. Change in blood pressure over time was modeled using linear mixed models with repeated measurement. Results: Hypertension was diagnosed in 2595 of 10,361 eligible patients. Of those, 869 initiated antihypertensive treatment. For patients treated for hypertension, we found a mean (95% confidence interval) decrease in systolic and diastolic blood pressure of −0.82 (−1.06 to −0.58) mm Hg and −0.89 (−1.05 to −0.73) mm Hg/yr, respectively. Factors associated with a decline in systolic blood pressure were baseline blood pressure, presence of chronic kidney disease, cardiovascular events, and the typical risk factors for cardiovascular disease. In patients with hypertension, increase in systolic blood pressure [(hazard ratio 1.18 (1.06 to 1.32) per 10 mm Hg increase], total cholesterol, smoking, age, and cumulative exposure to protease inhibitor–based and triple nucleoside regimens were associated with cardiovascular events. Conclusions: Insufficient control of hypertension was associated with increased risk of cardiovascular events indicating the need for improved management of hypertension in HIV-infected individuals.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Thurnheer Zürcher, Maria Christine

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0894-9255

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

21 Mar 2014 09:57

Last Modified:

23 Oct 2015 07:39

Publisher DOI:

10.1097/QAI.0b013e3182847cd0

Uncontrolled Keywords:

HIV infection, antiretroviral therapy, hypertension, cardiovascular event, risk factor

BORIS DOI:

10.7892/boris.44601

URI:

https://boris.unibe.ch/id/eprint/44601

Actions (login required)

Edit item Edit item
Provide Feedback