title: Hypertension and isolated office hypertension in HIV-infected patients determined by ambulatory blood pressure monitoring: prevalence and risk factors.
abstract: OBJECTIVE
  To determine prevalence and risk factors for hypertension and isolated office hypertension diagnosed by ambulatory blood pressure monitoring in HIV-infected patients.
  
  
  METHODS
  Cross-sectional study of 310 patients. A 24-hour ambulatory blood pressure monitoring procedure was performed on the nondominant arm in those patients showing office systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg.
  
  
  RESULTS
  Twenty patients (6.5%) had a prior diagnosis of hypertension. Hypertension was confirmed by ambulatory blood pressure monitoring in 26 patients and isolated office hypertension in 17 patients. Isolated office hypertension and hypertension prevalence were 5.5% (95% confidence interval: 3 to 8) and 14.8% (95% confidence interval; 10.8 to 18.8), respectively. Isolated office hypertension was present in 39% of patients with office hypertension. In the univariate analysis, variables significantly associated with hypertension were age, waist circumference, established cardiovascular disease, family history of hypertension, lipoatrophy, metabolic syndrome, duration of infection, CD4 nadir, HIV RNA <50 copies/mL, and antiretroviral treatment. In the multivariate analysis, family history of hypertension [odds ratio (OR): 2.24; P = 0.027], increasing age (OR: 1.08; P < 0.001), and number of different antiretroviral regimens (OR: 1.2; P = 0.001) were associated with hypertension and female gender (OR: 0.27; P = 0.02) had a protective effect.
  
  
  CONCLUSIONS
  The prevalence of hypertension using ambulatory blood pressure monitoring in HIV-infected patients was 15%. Because isolated office hypertension occurs in 39% of HIV-infected patients with office hypertension, ambulatory blood pressure monitoring could be useful to confirm the diagnosis of hypertension. Hypertension is strongly associated with family history of hypertension, male gender, age, and number of antiretroviral regimens.
authors.affiliation: Internal Medicine Department, HIV Unit, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana, Madrid, Spain. jibernardino.hulp@salud.madrid.org
authors.forename: Jose Ignacio
authors.initials: JI
authors.lastname: Bernardino
authors.forename: Marta
authors.initials: M
authors.lastname: Mora
authors.forename: Francisco Xavier
authors.initials: FX
authors.lastname: Zamora
authors.forename: Blanca
authors.initials: B
authors.lastname: Arribas
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Montes
authors.forename: Francisco
authors.initials: F
authors.lastname: Pascual-Pareja
authors.forename: Belen San
authors.initials: BS
authors.lastname: Jose
authors.forename: Jose Maria
authors.initials: JM
authors.lastname: Peña
authors.forename: Jose Ramon
authors.initials: JR
authors.lastname: Arribas
mesh_terms: D000328:Adult; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology