title: Higher Prevalence of Hypertension in HIV-1-Infected Patients on Combination Antiretroviral Therapy Is Associated With Changes in Body Composition and Prior Stavudine Exposure.
abstract: Individuals infected with human immunodeficiency virus (HIV) have a higher risk of cardiovascular disease, potentially partly mediated by a higher prevalence of hypertension. We therefore examined the prevalence and determinants of hypertension in HIV-1-infected patients compared with appropriate HIV-negative controls.
  
  
  
  Data from 527 HIV-1-infected and 517 HIV-uninfected participants at the time of enrollment into the ongoing AGEhIV Cohort Study were analyzed. Hypertension was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, and/or self-reported use of antihypertensive drugs.
  
  
  
  Hypertension prevalence was higher among HIV-1-infected individuals compared with controls (48.2% vs 36.4%; odds ratio [OR], 1.63; 95% confidence interval [CI], 1.27-2.09). In logistic regression models adjusted for age, sex, ethnicity, family history of hypertension, smoking, alcohol use, physical activity, and body mass index, the association between HIV and hypertension remained statistically significant (ORHIV, 1.65; 95% CI, 1.25-2.19), but was attenuated after additional adjustment for waist-to-hip ratio (ORHIV, 1.29; 95% CI, .95-1.76). Among HIV-1-infected individuals, particularly among those with mono/dual nucleoside reverse transcriptase inhibitor therapy prior to combination antiretroviral therapy, stavudine exposure was independently associated with hypertension (ORstavudine, 1.54; 95% CI, 1.04-2.30). This association was attenuated after additional adjustment for either waist-to-hip ratio (ORstavudine, 1.30; 95% CI, .85-1.96) or hip circumference (ORstavudine, 1.40; 95% CI, .93-2.11).
  
  
  
  Our findings suggest that changes in body composition, involving both abdominal obesity and stavudine-induced peripheral lipoatrophy, might contribute to the higher prevalence of hypertension in HIV-1-infected patients.
  
  
  
  NCT01466582.
authors.affiliation: Department of Global Health, Academic Medical Center, and Amsterdam Institute for Global Health and Development.
authors.forename: Rosan A
authors.initials: RA
authors.lastname: van Zoest
authors.affiliation: Department of Global Health, Academic Medical Center, and Amsterdam Institute for Global Health and Development Department of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam, Academic Medical Center HIV Monitoring Foundation.
authors.forename: Ferdinand W
authors.initials: FW
authors.lastname: Wit
authors.affiliation: Department of Global Health, Academic Medical Center, and Amsterdam Institute for Global Health and Development.
authors.forename: Katherine W
authors.initials: KW
authors.lastname: Kooij
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam, Academic Medical Center.
authors.forename: Marc
authors.initials: M
authors.lastname: van der Valk
authors.affiliation: Department of Neurology.
authors.forename: Judith
authors.initials: J
authors.lastname: Schouten
authors.affiliation: Department of Experimental Immunology, Academic Medical Center.
authors.forename: Neeltje A
authors.initials: NA
authors.lastname: Kootstra
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam, Academic Medical Center.
authors.forename: W Joost
authors.initials: WJ
authors.lastname: Wiersinga
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam, Academic Medical Center Department of Infectious Diseases Research Cluster, Public Health Service Amsterdam.
authors.forename: Maria
authors.initials: M
authors.lastname: Prins
authors.affiliation: Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Bert-Jan H
authors.initials: BJ
authors.lastname: van den Born
authors.affiliation: Department of Global Health, Academic Medical Center, and Amsterdam Institute for Global Health and Development Department of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam, Academic Medical Center HIV Monitoring Foundation.
authors.forename: Peter
authors.initials: P
authors.lastname: Reiss
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001823:Body Composition; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D015497:HIV-1; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D018119:Stavudine / Q000009:adverse effects* / Q000627:therapeutic use; D055105:Waist Circumference
chemical_list: D019380:Anti-HIV Agents; D018119:Stavudine
keywords: HIV-1 infection; hypertension; lipodystrophy; obesity; stavudine