[P13] EPIDEMIOLOGICAL EVIDENCE OF INCREASING BLOOD PRESSURE IN HIV-1-INFECTED INDIVIDUALS IN THE ERA OF HAART

2nd International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV

13-15 September 2000, Toronto, Canada

EPIDEMIOLOGICAL EVIDENCE OF INCREASING BLOOD PRESSURE IN HIV-1-INFECTED INDIVIDUALS IN THE ERA OF HAART

Antiviral Therapy 2000; 5(Suppl. 5):31 (abstract no. P13)

D Chow¹, S Souza¹, S Richmond-Crum² and C Shikuma¹
¹University of Hawaii, Honolulu, Hawaii; and ²State of Hawaii' Department of Health, Hawaii,USA

BACKGROUND: HAART has been associated with insulin resistance, low HDL cholesterol and central obesity, which are all components suggestive of Metabolic Syndrome X. The association with hypertension has been reported but is less clear.

OBJECTIVES: To describe the changes in systolic (SBP) and diastolic (DBP) blood pressure among Hawaii Sero-Positivity and Medical Management Project (HSPAMM) participants on or off HAART.

DESIGN: Analysis of the HSPAMM database from April 1989 to February 2000. HSPAMM is a State of Hawaii Department of Health programme that provides HIV-positive individuals living in the state with subsidized monitoring of their disease. The variables utilized were SBP, DBP, BMI, age, gender and ethnicity. HAART was defined as antiretroviral therapy containing a protease inhibitor and/or nonnucleoside reverse transcriptase inhibitor. Visits were all treated as single time-points for analysis purposes.

RESULTS: The database included 2302 participants, resulting in 9701 visits (22.1% of which were on HAART). A mean SBP of 121.7±14.5 mmHg for individuals on HAART and 118.4±14.1 mmHg for individuals not receiving HAART was observed (P<0.001).A mean DBP of 76.7±10.1 mmHg for individuals on HAART and 75.2±10.4 mmHg for individuals not receiving HAART was observed (P<0.001). These differences persisted after adjustment for age, sex, ethnicity and BMI.

CONCLUSIONS: While the results must be tempered by the observational nature of this study, they suggest that HAART is associated with an increase in mean SBP and DBP, independent of changes in BMI. Although the mean SBP and DBP were not in hypertensive levels, the rise in BP suggests that HAART is associated with increased autonomic function, another component of Metabolic Syndrome X, and that recent concerns are warranted regarding the cardiovascular risk in HIV-infected individuals on HAART.

Supported by PBRC RCMI/HARC Grant RRlAI03061

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