title: Hypertension Is a Key Feature of the Metabolic Syndrome in Subjects Aging with HIV.
abstract: With widespread and effective antiretroviral therapy, the life expectancy in the HIV population has dramatically improved over the last two decades. Consequently, as patients are aging with HIV, other age-related comorbidities, such as metabolic disturbances and cardiovascular disease (CVD), have emerged as important causes of morbidity and mortality. An overrepresentation of traditional cardiovascular risk factors (RF), toxicities associated with long exposure to antiretroviral therapy, together with residual chronic inflammation and immune activation associated with HIV infection are thought to predispose to these metabolic complications and to the excess risk of CVD observed in the HIV population. The metabolic syndrome (MS) represents a clustering of RF for CVD that includes abdominal obesity, hypertension, dyslipidemia and insulin resistance. Hypertension is a prevalent feature of the MS in HIV, in particular in the aging population, and constitutes an important RF for CVD. Physicians should screen their patients for metabolic and cardiovascular risk at the regular visits to reduce MS and the associated CVD risk among people aging with HIV, since many of RF are under-diagnosed and under-treated conditions. Interventions to reduce these RF can include lifestyle changes and pharmacological interventions such as antihypertensive and lipid-lowering therapy, and treatment of glucose metabolism disturbances. Changes in antiretroviral therapy to more metabolic neutral antiretroviral drugs may also be considered.
authors.affiliation: Infectious Diseases Department, Odense University Hospital, Sdr Boulevard 29, 5000, Odense C, Denmark. raquel@bisaurin.org.
authors.forename: Raquel
authors.initials: R
authors.lastname: Martin-Iguacel
authors.affiliation: "Lluita contra la SIDA" Foundation, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.|Universitat Autònoma de Barcelona, Barcelona, Spain.|Universitat de Vic-Universitat Central de Catalunya, Barcelona, Spain.
authors.forename: Eugènia
authors.initials: E
authors.lastname: Negredo
authors.affiliation: Department of Internal Medicine, Weill Bugando School of Medicine, PO Box 5034, Mwanza, Tanzania.|Center for Global Health, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Peck
authors.affiliation: Infectious Diseases Department, Odense University Hospital, Sdr Boulevard 29, 5000, Odense C, Denmark.
authors.forename: Nina
authors.initials: N
authors.lastname: Friis-Møller
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology*; D015897:Comorbidity; D019468:Disease Management; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000378:metabolism / Q000628:therapy; D024821:Metabolic Syndrome / Q000453:epidemiology*; D012307:Risk Factors
keywords: Antiretroviral therapy; Cardiovascular risk; HIV infection; Hypertension; Metabolic syndrome