Negative influence of HIV infection on day-night blood pressure variability.
OBJECTIVE
An attenuation of the physiological day-night blood pressure (BP) reduction is an important predictor of cardiovascular (CV) events and death. We compared circadian BP profile in treatment-naive HIV-infected patients and in healthy control subjects.


METHODS
Fifty-two antiretroviral therapy-naive HIV-infected patients (85% men, age 39 ± 11 years, BP 125/78 ± 11/9 mm Hg) and 156 age- and BP-matched HIV-negative controls (85% men, age 39 ± 10 years, BP 125/78 ± 9/7 mm Hg) underwent 24-hour BP monitoring. Subjects with a nocturnal reduction of systolic BP <10% were defined as "nondippers."


RESULTS
Nighttime BP was higher in HIV-infected subjects (113/69 ± 11/9 vs 109/67 ± 8/6 mm Hg, P = 0.008/0.005). Nocturnal systolic/diastolic BP reduction was 8.8/13.2% in HIV-positive patients and 11.7/17.2% in HIV negative (P = 0.002/0.001). The prevalence of "nondippers" was 35% and 15%, respectively (P = 0.003). In multivariate analysis, nocturnal systolic BP fall was negatively associated to HIV infection (β = -0.22, P = 0.001). HIV viral load, low CD4 cell count, and AIDS progression risk were all related with a flattened day-night BP profile (P < 0.01).


CONCLUSIONS
HIV infection per se negatively affects circadian BP rhythm. These findings, obtained in subjects without major CV risk factors and antiretroviral naive, suggest that day-night BP changes may play a role in the HIV-related increase in CV risk.
De Socio
Giuseppe Vittorio L
GV
Unit of Infectious Diseases, Santa Maria Hospital, Perugia, Italy. giuseppedesocio@yahoo.it
Bonfanti
Paolo
P
Martinelli
Canio
C
Ricci
Elena
E
Pucci
Giacomo
G
Marinoni
Marinella
M
Vitiello
Paola
P
Menzaghi
Barbara
B
Rizzardini
Giuliano
G
Schillaci
Giuseppe
G
D000328:Adult; D001794:Blood Pressure; D002940:Circadian Rhythm; D005260:Female; D015658:HIV Infections / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged