期刊
HIV MEDICINE
卷 10, 期 1, 页码 44-52出版社
WILEY-BLACKWELL PUBLISHING, INC
DOI: 10.1111/j.1468-1293.2008.00655.x
关键词
ambulatory; blood pressure monitoring; combination antiretroviral treatment; dipping pattern; essential hypertension; HIV
Objective Hypertensive cardiovascular complications are more closely associated with ambulatory blood pressure (ABP), particularly the attenuated diurnal blood pressure (BP) rhythm (i.e. a fall in systolic blood pressure < 10% during the night compared with the day), than with casual BP. The aim of the study was to assess the ABP pattern in an HIV-infected cohort in which hypertension was newly diagnosed. Methods ABP over 24 h was compared between 77 newly diagnosed, untreated hypertensive HIV-positive individuals and 76 HIV-uninfected untreated hypertensive controls. Results More HIV-infected subjects had an attenuated ABP rhythm with a reduced nocturnal fall than HIV-negative hypertensive control subjects (60 vs. 33%, respectively; P = 0.001). The dipping pattern was observed despite newly diagnosed hypertension, a low prevalence of microalbuminuria, and the absence of signs of overt kidney disease. Furthermore, the prevalence of nondipping in the HIV-infected subjects was independent of combination antiretroviral treatment. Multiple logistic regression analysis with dipping pattern as the dependent variable showed that IIIV status was an independent predictor of nondipping BP [P = 0.002; odds ratio (OR) 0.33; 95% confidence interval (CI) 0.17- 0.66]; casual SBP (P = 0.37; OR 1.001; 95% CI 0.99-1.04) and microalbuminuria (P = 0.39; OR 1.56; 95% CI 0.57-4.28) were not associated with dipping pattern. Conclusions The prevalence of a nondipping BP pattern in HIV-infected subjects with newly diagnosed hypertension who had not received antihypertensive treatment was high and significantly greater than in hypertensive control subjects.
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