5th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV 8–11 July 2003, Le Meridien Montparnasse, Paris, France

PULSE PRESSURE: ANOTHER CARDIOVASCULAR RISK FACTOR IN HIV-INFECTED PATIENTS? TRANSVERSAL STUDY IN A COHORT FROM A SINGLE INSTITUTION

Antiviral Therapy 2003; 8:L30 (abstract 36)

R Palacios, J Santos, J Ruiz, M González and M Márquez
Hospital Virgen de la Victoria, Malaga, Spain

BACKGROUND: Pulse pressure (PP) is considered an independent cardiovascular risk factor that is usually associated with other cardiovascular risk factors in the general population. A high PP is >50 mmHg.

OBJECTIVE: To analyse PP in a cohort of HIV-infected patients and identify factors associated with high PP values.

METHODS: A transversal study of all outpatients who attended the institution between 05/02–09/02 was undertaken. Demographic features, tobacco use, lipid profile, personal and familial history of ischemic heart disease and epidemiological, clinical, immunovirological and therapeutic characteristics related to HIV infection were collected. Multiple logistic regression was used to identify factors associated with high levels of PP (statistics programme, SPSS).

RESULTS: Six-hundred-and-one patients. Mean age, 42.1 years; men, 80.8%; sexual HIV transmission, 60.7%; AIDS, 40.3%; antiretroviral (ARV) users, 81.1%, for a mean time of 59.4 (1–149) months. Prevalence of high blood systolic pressure was 24% and high diastolic pressure 19%. Mean PP was 47 (8–117, median 45) mmHg. PP was elevated in 260 (43.4%) patients. Homosexual (HMX) HIV-transmission patients had a higher PP than injecting drug user (IDU) and heterosexual (HTX) ones (50.2 vs 45.3 and 45.7; P<0.001 and P<0.008). ARV use was also associated with a higher PP (47.8 vs 44.3; P<0.014). In the univariate analysis, high PP was associated with an older age, male sex, higher body mass index (BMI), longer time on highly active antiretroviral therapy (HAART), tobacco and diabetes; but in the multivariate analysis it was only related to age (OR 1.02; 95% CI: 1.0–1.04; P=0.003) and sex (OR 2.2; 95% CI: 1.2–3.8; P=0.003).

CONCLUSIONS: The prevalence of an elevated PP in HIV-infected patients is high. HAART and HMX HIV-risk are associated with a high PP. But, in the multivariate analysis only age and sex were significant. Prospective studies to analyse the influence of this factor on the cardiovascular risk of HIV-infected patients are needed.

Presenting author: R Palacios

2003-07-08
36

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