Keywords HIV infection cardiovascular risk pulse wave velocity aortic stiffness A B S T R A C TBackground: The risk of Cardiovascular (CV) events is higher in HIV-infected patients (HIV+) compared to HIV-uninfected persons (HIV−). Large artery stiffness, a well-documented predictor of adverse CV prognosis, may mediate this enhanced risk. It is usually assessed by measuring aortic Pulse Wave Velocity (aPWV). Studies examining arterial stiffness in HIV+ yielded inconsistent results. We performed a meta-analysis with the aim to evaluate the association of HIV infection and its therapy [Antiretroviral Therapy (ART)] with aPWV. Design and Method:The Standardized Mean Difference (SMD) and corresponding 95% confidence intervals were calculated for aPWV in different comparison groups. Statistical heterogeneity, assessed by Q-test and I 2 statistic, was observed in all these comparisons. Therefore, random effects model was implemented.Results: In a total of 12 studies, naive HIV+ (n = 547) showed increased aPWV compared to HIV− (n = 864): SMD = 0.333 (0.125-0.542), p < 0.002. A total of 22 studies were identified comparing HIV+ treated with ART (n = 3348) to HIV− (n = 2547) showing higher values of aPWV in the former than in latter: SMD = 0.391 (0.225-0.556), p < 0.001. In 10 studies, HIV+ treated with ART (n = 761) exhibited greater aPWV values than those of naive HIV+ (n = 457): SMD = 0.262 (0.006-0.518), p = 0.045. Conclusion:Our meta-analysis seems to suggest that HIV infection "per se" and ART may impair aortic distensibility. However, interpretation of our results needs caution due to between-study heterogeneity and some potential publication biases.

Chronic kidney disease (CKD) is a progressive disease that affects > 10% of the total population worldwide or >800 million people. CKD poses a particularly heavy burden in low- and middle-income countries, which are least able to cope with its consequences. It has become one of the leading causes of death worldwide and is one of the few non-communicable diseases where the number of related deaths has increased over the last two decades. The high number of people affected, and the significant negative impact of CKD should be a reason to increase efforts to improve prevention and treatment. The interaction of lung and kidney leads to highly complex and difficult clinical scenarios. CKD significantly affects the physiology of the lung by altering fluid homeostasis, acid-base balance and vascular tone. In the lung, haemodynamic disturbances lead to the development of alterations in ventilatory control, pulmonary congestion, capillary stress failure and pulmonary vascular disease. In the kidney, haemodynamic disturbances lead to sodium and water retention and the deterioration of renal function. In this article, we would like to draw attention to the importance of harmonising the definitions of clinical events in pneumology and renal medicine. We would also like to highlight the need for pulmonary function tests in routine clinical practise for the management of patients with CKD, in order to find new concepts for pathophysiological based disease-specific management strategies.

Objective: The objective was to assess the differences about the prevalence of high blood pressure values in adolescents by applying the 2016 ESH and the 2017 AAP hypertension guidelines and analyze the relationship of pressure increases with lifestyles and potentially risky behaviors, which in Italy are little investigated. Design and method: Blood pressure levels of 1301 students aged between 13 and 20 were recorded. Two questionnaires were administered, one related to anamnestic data and anthropometric parameters and a second one, combined with the measurement of blood pressure, investigated the prevalence of hypertension and its relationship with lifestyle. Three blood pressure and heart rate measurements were taken and the average of these measurements was calculated. For the diagnosis of increased blood pressure both ESH and AAP criteria were considered. For the definition of the height centiles as well as for the BMI, reference was made to the tables produced by WHO 2007. Results: The main result concern the greater prevalence of high blood pressure values by applying new AAP criteria (14,8%)than ESH guidelines (7,5%). In our study we found significant correlation of systolic values and anthropometrics variables: weight (r = 0,342) height (r = 0,321) and BMI (r = 0,318) in the entire population. The condition of overweight in hypertensive subjects in comparison to normotensive was evident, while the prevalence of obesity despite being tendentially greater in hypertensives was not significantly higher. Higher SBP (systolic blood pressure) and DBP (diastolic blood pressure) values are associated with a higher mean heart rate (88 ± 18 bpm). No significant correlations was found with smoking, height and sex. Conclusions: At the best of our knowledge, this study is the first in our country, which investigates the prevalence of hypertension in adolescents, after the publication of 2017 AAP guidelines. Results shows how hypertension is not a rare phenomenon in this age group and confirm that it deserves more attention and following studies.