8C.08

Jp, Baguet; Sosner, P.; Delsart, Pascal; S, Jost; Tamisier, Renaud; Pépin, Jean‐Louis

doi:10.1097/01.hjh.0000467653.00544.5f

Cited by 3 publications

(1 citation statement)

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“…In the general population, sleep apnea, sleepiness, and sleep disturbances have been associated with increased CVD risk [68][69][70][71]. Percent nighttime systolic BP has been reported to have an inverse correlation (r=−0.578; p=0.001) with apnea-hypopnea index, and one study found that after treatment of sleep apnea with continuous positive airway pressure, nighttime systolic BP was reduced by 5.5 mmHg (p=0.022) [24,25]. In a study of individuals, 19-64 years of age with stage 1 hypertension and not taking antihypertensive medication, 70 % of poor sleepers (according to the Pittsburgh Quality Sleep Index) had a nondipping BP, compared to 44 % of good sleepers [72].…”

Section: Sleepmentioning

confidence: 94%

Mechanisms Influencing Circadian Blood Pressure Patterns Among Individuals with HIV

et al. 2015

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HIV+ individuals have an increased risk for cardiovascular disease (CVD), but the mechanisms behind this association are poorly understood. While hypertension is a well-established CVD risk factor, clinic-based blood pressure (BP) assessment by itself cannot identify several important BP patterns, including white coat hypertension, masked hypertension, nighttime hypertension, and nighttime BP dipping. These BP patterns can be identified over a 24-h period by ambulatory BP monitoring (ABPM). In this review, we provide an overview of the potential value of conducting ABPM in HIV+ individuals. ABPM phenotypes associated with increased CVD risk include masked hypertension (i.e., elevated out-of-clinic BP despite non-elevated clinic BP), nighttime hypertension, and a non-dipping BP pattern (i.e., a drop in BP of <10 % from daytime to nighttime). These adverse ABPM phenotypes may be highly relevant in the setting of HIV infection, given that increased levels of inflammatory biomarkers, high psychosocial burden, high prevalence of sleep disturbance, and autonomic dysfunction have been commonly reported in HIV+ persons. Additionally, although antiretroviral therapy (ART) is associated with lower AIDS-related morbidity and CVD risk, the mitochondrial toxicity, oxidative stress, lipodystrophy, and insulin resistance associated with long-term ART use potentially lead to adverse ABPM phenotypes. Existing data on ABPM phenotypes in the setting of HIV are limited, but suggest an increased prevalence of a non-dipping BP pattern. In conclusion, identifying ABPM phenotypes may provide crucial information regarding the mechanisms underlying the excess CVD risk in HIV+ individuals.

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Section: Sleepmentioning

confidence: 94%

Mechanisms Influencing Circadian Blood Pressure Patterns Among Individuals with HIV

et al. 2015

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The Challenges of Precision Medicine in Obstructive Sleep Apnea

Gileles‐Hillel

Gozal

2016

Sleep Medicine Clinics

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Ambulatory Blood Pressure Monitoring in Individuals with HIV: A Systematic Review and Meta-Analysis

et al. 2016

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IntroductionAbnormal diurnal blood pressure (BP) rhythms may contribute to the high cardiovascular disease risk in HIV-positive (HIV+) individuals. To synthesize the current literature on ambulatory BP monitoring (ABPM) in HIV+ individuals, a systematic literature review and meta-analysis were performed.MethodsMedical databases were searched through November 11, 2015 for studies that reported ABPM results in HIV+ individuals. Data were extracted by 2 reviewers and pooled differences between HIV+ and HIV-negative (HIV-) individuals in clinic BP and ABPM measures were calculated using random-effects inverse variance weighted models.ResultsOf 597 abstracts reviewed, 8 studies with HIV+ cohorts met the inclusion criteria. The 420 HIV+ and 714 HIV- individuals in 7 studies with HIV- comparison groups were pooled for analyses. The pooled absolute nocturnal systolic and diastolic BP declines were 3.16% (95% confidence interval [CI]: 1.13%, 5.20%) and 2.92% (95% CI: 1.64%, 4.19%) less, respectively, in HIV+ versus HIV- individuals. The pooled odds ratio for non-dipping systolic BP (nocturnal systolic BP decline <10%) in HIV+ versus HIV- individuals was 2.72 (95% CI: 1.92, 3.85). Differences in mean clinic, 24-hour, daytime, or nighttime BP were not statistically significant. I2 and heterogeneity chi-squared statistics indicated the presence of high heterogeneity for all outcomes except percent DBP dipping and non-dipping SBP pattern.ConclusionsAn abnormal diurnal BP pattern may be more common among HIV+ versus HIV- individuals. However, results were heterogeneous for most BP measures, suggesting more research in this area is needed.

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8C.08

Cited by 3 publications

References 0 publications

Mechanisms Influencing Circadian Blood Pressure Patterns Among Individuals with HIV

Mechanisms Influencing Circadian Blood Pressure Patterns Among Individuals with HIV

The Challenges of Precision Medicine in Obstructive Sleep Apnea

Ambulatory Blood Pressure Monitoring in Individuals with HIV: A Systematic Review and Meta-Analysis

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