Key result
HIV infection in untreated hypertensive individuals was associated with a higher prevalence of a nondipping blood pressure pattern compared to uninfected controls (60% vs 33%; P=0.001).
Why the study?
Does HIV infection increase the prevalence of nondipping blood pressure patterns in newly diagnosed, untreated hypertensive individuals?
Observational (n=153)
Does HIV infection increase the prevalence of nondipping blood pressure patterns in newly diagnosed, untreated hypertensive individuals?
Odds Ratio: 0.33 (95% CI 0.17–0.66)
Absolute Event Rate: 60% vs 33%
p-value: p=0.002
HIV infection is independently associated with a higher prevalence of nondipping blood pressure patterns in newly diagnosed, untreated hypertensive patients.
May prompt ambulatory BP monitoring in HIV-positive hypertensives; leaves open prognostic and therapeutic implications.
OBJECTIVE: Hypertensive cardiovascular complications are more closely associated with ambulatory blood pressure (ABP), particularly the attenuated diurnal blood pressure (BP) rhythm (i.e. a fall in systolic blood pressure <10% during the night compared with the day), than with casual BP. The aim of the study was to assess the ABP pattern in an HIV-infected cohort in which hypertension was newly diagnosed. METHODS: ABP over 24 h was compared between 77 newly diagnosed, untreated hypertensive HIV-positive individuals and 76 HIV-uninfected untreated hypertensive controls. RESULTS: More HIV-infected subjects had an attenuated ABP rhythm with a reduced nocturnal fall than HIV-negative hypertensive control subjects (60 vs. 33%, respectively; P=0.001). The dipping pattern was observed despite newly diagnosed hypertension, a low prevalence of microalbuminuria, and the absence of signs of overt kidney disease. Furthermore, the prevalence of nondipping in the HIV-infected subjects was independent of combination antiretroviral treatment. Multiple logistic regression analysis with dipping pattern as the dependent variable showed that HIV status was an independent predictor of nondipping BP [P=0.002; odds ratio (OR) 0.33; 95% confidence interval (CI) 0.17-0.66]; casual SBP (P=0.37; OR 1.001; 95% CI 0.99-1.04) and microalbuminuria (P=0.39; OR 1.56; 95% CI 0.57-4.28) were not associated with dipping pattern. CONCLUSIONS: The prevalence of a nondipping BP pattern in HIV-infected subjects with newly diagnosed hypertension who had not received antihypertensive treatment was high and significantly greater than in hypertensive control subjects.
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Bækken et al. (2008) conducted an observational in Newly diagnosed, untreated hypertension (n=153). HIV infection vs. HIV-uninfected controls was evaluated on Attenuated diurnal blood pressure rhythm (nondipping BP pattern) (OR 0.33, 95% CI 0.17-0.66, p=0.002). HIV infection in untreated hypertensive individuals was associated with a higher prevalence of a nondipping blood pressure pattern compared to uninfected controls (60% vs 33%; P=0.001).
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