title: Hypertension and antihypertensive treatment in HIV-infected individuals. A longitudinal cohort study.
abstract: OBJECTIVE
  Hypertension is a significant contributor to cardiovascular disease in HIV-infected individuals. The purposes of this study were to assess the development of new-onset hypertension and the use of antihypertensive treatment and blood pressure (BP) control.
  
  
  METHODS
  In a longitudinal study of 434 HIV-infected individuals (43±11 years, 72% males, follow-up 3.4±0.8 years), standardized BP recordings were undertaken at three clinical visits both at baseline and at follow-up, and cardiovascular risk factors were monitored. Adjusted odds ratio (OR) for new-onset hypertension (systolic BP≥140 and/or diastolic BP≥90 mmHg or initiation of antihypertensive treatment) was calculated using multiple logistic regression analyses.
  
  
  RESULTS
  New-onset hypertension occurred with an incidence of 29.8 per 1000 person-years (95% CI 20.3-42.2). HIV duration (OR=1.10, 95% CI 1.01-1.20), mean BP (1.24, 95% CI 1.13-1.35) and abnormal urinary albumin excretion (OR=5.47, 95% CI 1.07-27.85) were independent predictors for new-onset hypertension after adjustment. Use of antihypertensive treatment increased threefold from 17% to 49% in hypertensive patients. Adequate BP control was obtained in 22% of patients on antihypertensive therapy.
  
  
  CONCLUSIONS
  HIV duration predicted new-onset hypertension, which could suggest involvement of low-grade inflammation; this hypothesis needs to be further explored. Despite increased use of antihypertensive treatment, enhanced awareness and adequate treatment of hypertension are still warranted in HIV-infected individuals.
authors.affiliation: Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway. i.w.manner@medisin.uio.no
authors.forename: Ingjerd W
authors.initials: IW
authors.lastname: Manner
authors.forename: Morten
authors.initials: M
authors.lastname: Baekken
authors.forename: Olav
authors.initials: O
authors.lastname: Oektedalen
authors.forename: Ingrid
authors.initials: I
authors.lastname: Os
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology / Q000821:virology*; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D000959:Antihypertensive Agents