title: Risk of cardiovascular events and blood pressure control in hypertensive HIV-infected patients: Swiss HIV Cohort Study (SHCS).
abstract: BACKGROUND
  Prevalence of hypertension in HIV infection is high, and information on blood pressure control in HIV-infected individuals is insufficient. We modeled blood pressure over time and the risk of cardiovascular events in hypertensive HIV-infected individuals.
  
  
  METHODS
  All patients from the Swiss HIV Cohort Study with confirmed hypertension (systolic or diastolic blood pressure above 139 or 89 mm Hg on 2 consecutive visits and presence of at least 1 additional cardiovascular risk factor) between April 1, 2000 and March 31, 2011 were included. Patients with previous cardiovascular events, already on antihypertensive drugs, and pregnant women were excluded. Change in blood pressure over time was modeled using linear mixed models with repeated measurement.
  
  
  RESULTS
  Hypertension was diagnosed in 2595 of 10,361 eligible patients. Of those, 869 initiated antihypertensive treatment. For patients treated for hypertension, we found a mean (95% confidence interval) decrease in systolic and diastolic blood pressure of -0.82 (-1.06 to -0.58) mm Hg and -0.89 (-1.05 to -0.73) mm Hg/yr, respectively. Factors associated with a decline in systolic blood pressure were baseline blood pressure, presence of chronic kidney disease, cardiovascular events, and the typical risk factors for cardiovascular disease. In patients with hypertension, increase in systolic blood pressure [(hazard ratio 1.18 (1.06 to 1.32) per 10 mm Hg increase], total cholesterol, smoking, age, and cumulative exposure to protease inhibitor-based and triple nucleoside regimens were associated with cardiovascular events.
  
  
  CONCLUSIONS
  Insufficient control of hypertension was associated with increased risk of cardiovascular events indicating the need for improved management of hypertension in HIV-infected individuals.
authors.affiliation: *Division of Infectious Diseases, Hirslanden Klinik St. Anna, Lucerne, Switzerland; †Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland; ‡Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland; §Division of Infectious Diseases, Regional Hospital of Lugano, Lugano, Switzerland; ‖Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland; ¶Division of Infectious Diseases, University Hospital Lausanne, Lausanne, Switzerland; #Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland; **Division of Infectious Diseases, University Hospital Bern and University of Bern, Bern, Switzerland; and ††Division of Infectious Diseases, University Hospital of Geneva, Geneva, Switzerland.
authors.forename: Reto
authors.initials: R
authors.lastname: Nüesch
authors.forename: Qing
authors.initials: Q
authors.lastname: Wang
authors.forename: Luigia
authors.initials: L
authors.lastname: Elzi
authors.forename: Enos
authors.initials: E
authors.lastname: Bernasconi
authors.forename: Rainer
authors.initials: R
authors.lastname: Weber
authors.forename: Matthias
authors.initials: M
authors.lastname: Cavassini
authors.forename: Pietro
authors.initials: P
authors.lastname: Vernazza
authors.forename: Maria C
authors.initials: MC
authors.lastname: Thurnheer
authors.forename: Alexandra
authors.initials: A
authors.lastname: Calmy
authors.forename: Manuel
authors.initials: M
authors.lastname: Battegay
authors.forename: Heiner C
authors.initials: HC
authors.lastname: Bucher
mesh_terms: D000328:Adult; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000150:complications*; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D013557:Switzerland