title: Negative influence of HIV infection on day-night blood pressure variability.
abstract: 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.
authors.affiliation: Unit of Infectious Diseases, Santa Maria Hospital, Perugia, Italy. giuseppedesocio@yahoo.it
authors.forename: Giuseppe Vittorio L
authors.initials: GV
authors.lastname: De Socio
authors.forename: Paolo
authors.initials: P
authors.lastname: Bonfanti
authors.forename: Canio
authors.initials: C
authors.lastname: Martinelli
authors.forename: Elena
authors.initials: E
authors.lastname: Ricci
authors.forename: Giacomo
authors.initials: G
authors.lastname: Pucci
authors.forename: Marinella
authors.initials: M
authors.lastname: Marinoni
authors.forename: Paola
authors.initials: P
authors.lastname: Vitiello
authors.forename: Barbara
authors.initials: B
authors.lastname: Menzaghi
authors.forename: Giuliano
authors.initials: G
authors.lastname: Rizzardini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Schillaci
mesh_terms: D000328:Adult; D001794:Blood Pressure; D002940:Circadian Rhythm; D005260:Female; D015658:HIV Infections / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged