title: Symmetric ambulatory arterial stiffness index and 24-h pulse pressure in HIV infection: results of a nationwide cross-sectional study.
abstract: OBJECTIVE
  HIV infection has been associated with increased cardiovascular risk. Twenty-four-hour ambulatory blood pressure (BP) is a more accurate and prognostically relevant measure of an individual's BP load than office BP, and the ambulatory BP-derived ambulatory arterial stiffness index (AASI) and symmetric AASI (s-AASI) are established cardiovascular risk factors.
  
  
  METHODS
  In the setting of the HIV and HYpertension (HIV-HY) study, an Italian nationwide survey on high BP in HIV infection, 100 HIV-infected patients with high-normal BP or untreated hypertension (72% men, age 48 ± 10 years, BP 142/91 ± 12/7 mmHg) and 325 HIV-negative individuals with comparable age, sex distribution, and office BP (68% men, age 48 ± 10 years, BP 141/90 ± 11/8 mmHg) underwent 24-h ambulatory BP monitoring.
  
  
  RESULTS
  Despite having similar office BP, HIV-infected individuals had higher 24-h SBP (130.6 ± 14 vs. 126.4 ± 10 mmHg) and pulse pressure (49.1 ± 9 vs. 45.9 ± 7 mmHg, both P < 0.001), and a lower day-night reduction of mean arterial pressure (14.3 ± 9 vs. 16.3 ± 7%, P = 0.025). Both s-AASI and AASI were significantly higher in HIV patients (s-AASI, 0.22 ± 0.18 vs. 0.11 ± 0.15; AASI, 0.46 ± 0.22 vs. 0.29 ± 0.17; both P <0.001). In a multivariate regression, s-AASI was independently predicted by HIV infection (β = 0.252, P <0.001), age, female sex, and 24-h SBP. In HIV patients, s-AASI had an inverse relation with CD4 cell count (Spearman's ρ -0.24, P = 0.027).
  
  
  CONCLUSIONS
  Individuals with HIV infection and borderline or definite hypertension have higher symmetric AASI and 24-h systolic and pulse pressures than HIV-uninfected controls matched by office BP. High ambulatory BP may play a role in the HIV-related increase in cardiovascular risk.
authors.affiliation: The Università di Perugia and Struttura Complessa di Medicina Interna, Ospedale S. Maria, Terni, Italy. skill@unipg.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Schillaci
authors.forename: Paolo
authors.initials: P
authors.lastname: Maggi
authors.forename: Giordano
authors.initials: G
authors.lastname: Madeddu
authors.forename: Giacomo
authors.initials: G
authors.lastname: Pucci
authors.forename: Elena
authors.initials: E
authors.lastname: Mazzotta
authors.forename: Giovanni
authors.initials: G
authors.lastname: Penco
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Orofino
authors.forename: Barbara
authors.initials: B
authors.lastname: Menzaghi
authors.forename: Stefano
authors.initials: S
authors.lastname: Rusconi
authors.forename: Laura
authors.initials: L
authors.lastname: Carenzi
authors.forename: Benedetto M
authors.initials: BM
authors.lastname: Celesia
authors.forename: Canio
authors.initials: C
authors.lastname: Martinelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Bonfanti
authors.forename: Giuseppe Vittorio
authors.initials: GV
authors.lastname: De Socio
mesh_terms: D000328:Adult; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D059289:Vascular Stiffness