Hypertension is Common among HIV-Infected Persons, But Not Associated with HAART

Abstract

Background: With improved survival after the introduction of highly active antiretroviral therapy (HAART), non-AIDS-related morbidity and mortality have come to the forefront in the management of HIV patients. HAART has been linked to the development of several risk factors for cardiovascular disease including insulin resistance and hyperlipidemia, but its influence on hypertension requires further study. Methods: We performed a cross-sectional study of HIV-infected persons at two large HIV clinics to evaluate the prevalence and factors associated with hypertension. Hypertension was defined by at least two blood pressure measurements >140/90 mmHg or the use of an antihypertensive medication. Statistical analyses included multivariate logistic regression models. Results: We studied 707 HIV-infected adults with a median age of 41 years (IQR 36-46), 92% were male, 49% were Caucasian, and 72% were receiving HAART. The overall prevalence of hypertension was 31% and was similar among those receiving and not receiving HAART (32% vs. 29%, p = 0.47). Factors associated with hypertension in the multivariate model included increasing age, longer duration of HIV, higher body mass index, and diabetes, with a trend for African American ethnicity. Conclusions: Hypertension is common among HIV-infected persons and is associated with established risk factors, but not with HAART use. Given the high prevalence of hypertension and its association with duration of HIV infection, other factors such as virally-mediated endothelial changes or immune activation may play a role. Further investigations are needed.