Journal Article

Hypertension in HIV-1-infected patients and its impact on renal and cardiovascular integrity

Oliver Jung, Markus Bickel, Tilmann Ditting, Volker Rickerts, Thomas Welk, Eilke B. Helm, Schlomo Staszewski and Helmut Geiger

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 19, issue 9, pages 2250-2258
Published in print September 2004 | ISSN: 0931-0509
Published online July 2004 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfh393
Hypertension in HIV-1-infected patients and its impact on renal and cardiovascular integrity

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Background. With increasing life spans of HIV-infected individuals under highly active antiretroviral therapy, long-term consequences of the chronic infection and antiretroviral treatment are becoming more prevalent. Data on prevalence and consequences of hypertension are limited, but recent studies suggest that HIV-infected individuals are at a higher risk of developing hypertension.

Methods. In this prospective study, HIV-1-infected patients from the Frankfurt AIDS Cohort Study (FACS) were followed for 1 year to determine the frequency of systemic hypertension and to assess the associated clinical and demographic factors.

Results. A total 214 HIV-1-infected patients, predominantly Caucasian males, participated in the study. Prevalence of systemic hypertension was 29%. The groups of hypertensive and normotensive individuals were comparable in terms of ethnic background and duration of infection. As in the general population, hypertensive subjects were older (49.1±11.1 vs 39.0±8.1 years; P<0.0001) and waist-to-hip ratio was higher than in normotensive individuals (0.99±0.07 vs 0.93±0.08; P<0.0001). Hypertension was associated with a much higher frequency of persistent proteinuria (41.1% vs 2.8%; P<0.001), coronary heart disease (16.1% vs 1.3%; P<0.0001) and myocardial infarction (8.1% vs 0.7%; P<0.005), whereas most cardiovascular risk factors were similar in both groups.

Conclusions. Our data do not demonstrate any association between the presence of hypertension and antiretroviral therapy or immune status. However, hypertension seems to have a high impact on the existing risk for premature cardiovascular disease. Furthermore, overt proteinuria is frequent in HIV-1 infection with hypertension and might be due to hypertensive nephrosclerosis as well as yet undefined renal disease in these patients.

Keywords: cardiovascular disease; HIV; hypertension; proteinuria

Journal Article.  5363 words. 

Subjects: Nephrology

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