Key result
HIV infection was associated with a significantly higher likelihood of a non-dipping systolic blood pressure pattern compared to HIV-negative individuals (OR 2.72).
Why the study?
Do HIV-positive individuals have abnormal diurnal blood pressure patterns on ambulatory blood pressure monitoring compared to HIV-negative individuals?
Meta-Analysis (n=1,134)
Do HIV-positive individuals have abnormal diurnal blood pressure patterns on ambulatory blood pressure monitoring compared to HIV-negative individuals?
Odds Ratio: 2.72 (95% CI 1.92–3.85)
HIV-positive individuals have a significantly higher likelihood of abnormal diurnal blood pressure patterns, specifically non-dipping systolic BP, which may contribute to their increased cardiovascular risk.
INTRODUCTION: Abnormal diurnal blood pressure (BP) rhythms may contribute to the high cardiovascular disease risk in HIV-positive (HIV+) individuals. To synthesize the current literature on ambulatory BP monitoring (ABPM) in HIV+ individuals, a systematic literature review and meta-analysis were performed. METHODS: Medical databases were searched through November 11, 2015 for studies that reported ABPM results in HIV+ individuals. Data were extracted by 2 reviewers and pooled differences between HIV+ and HIV-negative (HIV-) individuals in clinic BP and ABPM measures were calculated using random-effects inverse variance weighted models. RESULTS: Of 597 abstracts reviewed, 8 studies with HIV+ cohorts met the inclusion criteria. The 420 HIV+ and 714 HIV- individuals in 7 studies with HIV- comparison groups were pooled for analyses. The pooled absolute nocturnal systolic and diastolic BP declines were 3.16% (95% confidence interval [CI]: 1.13%, 5.20%) and 2.92% (95% CI: 1.64%, 4.19%) less, respectively, in HIV+ versus HIV- individuals. The pooled odds ratio for non-dipping systolic BP (nocturnal systolic BP decline <10%) in HIV+ versus HIV- individuals was 2.72 (95% CI: 1.92, 3.85). Differences in mean clinic, 24-hour, daytime, or nighttime BP were not statistically significant. I2 and heterogeneity chi-squared statistics indicated the presence of high heterogeneity for all outcomes except percent DBP dipping and non-dipping SBP pattern. CONCLUSIONS: An abnormal diurnal BP pattern may be more common among HIV+ versus HIV- individuals. However, results were heterogeneous for most BP measures, suggesting more research in this area is needed.
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Kent et al. (2016) conducted a meta-analysis in HIV infection (n=1,134). HIV infection vs. HIV-negative individuals was evaluated on Non-dipping systolic blood pressure pattern (nocturnal systolic BP decline <10%) (OR 2.72, 95% CI 1.92-3.85). HIV infection was associated with a significantly higher likelihood of a non-dipping systolic blood pressure pattern compared to HIV-negative individuals (OR 2.72).
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