title: Association between HIV infection and attenuated diurnal blood pressure rhythm in untreated hypertensive individuals.
abstract: 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.
authors.affiliation: Department of Infectious Diseases, Ullevaal University Hospital, Oslo, Norway. morten.baekken@medisin.uio.no
authors.forename: M
authors.initials: M
authors.lastname: Baekken
authors.forename: I
authors.initials: I
authors.lastname: Os
authors.forename: A
authors.initials: A
authors.lastname: Stenehjem
authors.forename: L
authors.initials: L
authors.lastname: Sandvik
authors.forename: O
authors.initials: O
authors.lastname: Oektedalen
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000503:physiopathology; D002940:Circadian Rhythm / Q000502:physiology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000503:physiopathology; D015497:HIV-1; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009664:Norway; D012307:Risk Factors