Higher Risk of Abdominal Obesity, Elevated Low-Density Lipoprotein Cholesterol, and Hypertriglyceridemia, but not of Hypertension, in People Living With Human Immunodeficiency Virus (HIV): Results From the Copenhagen Comorbidity in HIV Infection Study

Gelpi, Marco; Afzal, Shoaib; Lundgren, Jens D; Ronit, Andreas; Roen, Ashley; Mocroft, Amanda; Gerstoft, Jan; Lebech, Anne‐Mette; Lindegaard, Birgitte; Kofoed, Klaus F.; Nordestgaard, Børge G.; Nielsen, Susanne Dam

doi:10.1093/cid/ciy146

Cited by 76 publications

(88 citation statements)

References 37 publications

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“…This is in accord with a Norwegian study of similar sample size where rates of hypertension declined from 23% in PLWH on cART to 13% among PLWH cART‐naïve . Again, a recent case‐control study from Denmark found PLWH had a lower risk of hypertension compared with age‐ and sex‐matched controls. Hypertension was significantly more common among PLWH on cART than cART‐naïve participants in the present study.…”

Section: Discussionsupporting

confidence: 87%

Characteristics of hypertension among people living with HIV in Ghana: Impact of new hypertension guideline

Nichols

Singh

Hardy

et al. 2019

J of Clinical Hypertension

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Data on the burden of hypertension among people living with HIV (PLWH) in Africa are limited, especially after new expert consensus hypertension guidelines were published in 2017. The authors sought to assess the prevalence and factors associated with hypertension among PLWH. This is a cross‐sectional study involving PLWH on combination antiretroviral therapy (cART) (n = 250) compared with sex‐matched cART‐naïve PLWH (n = 201) in Ghana. Hypertension was defined as blood pressure ≥ 140/90 mm Hg or use of antihypertensive drugs. The authors also assessed the prevalence and predictors associated with hypertension using the recent guideline recommended cutoff BP ≥ 130/80 mm Hg. Multivariate logistic regression models were fitted to identify factors associated with hypertension among PLWH. The mean age of PLWH on cART was 45.7 ± 8.6 years, and 42.9 ± 8.8 years among PLWH cART‐naive with 81% of study participants being women. The prevalence of hypertension among PLWH on cART and PLWH cART‐naïve was 36.9% and 23.4%, P = 0.002 at BP ≥ 140/90 mm Hg and 57.2% and 42.3%, respectively, P = 0.0009, at BP ≥ 130/80 mm Hg. Factors associated with hypertension at BP ≥ 140/90 mm Hg in the PLWH group with adjusted odds ratio (95% CI) were increasing age, 2.08 (1.60‐2.71) per 10 years, and body mass index, 1.53 (1.24‐1.88) per 5 kg/m2 rise. At BP ≥ 130/80 mm Hg, cART exposure, aOR of 1.77 (95% CI: 1.20‐2.63), family history of hypertension, aOR of 1.43 (1.12‐1.83), and hypertriglyceridemia, aOR of 0.54 (0.31‐0.93), were associated with hypertension. Among PLWH, cART exposure was associated with higher prevalence of hypertension per the new guideline definition, a finding which warrants further investigation and possible mitigation.

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Section: Discussionsupporting

confidence: 87%

Characteristics of hypertension among people living with HIV in Ghana: Impact of new hypertension guideline

Nichols

Singh

Hardy

et al. 2019

J of Clinical Hypertension

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“…For comparison, the prevalence of hypertension was 44% among PLHIV and 58% among controls in a recent large Danish cohort study of predominantly well-treated PLHIV [8]. In that study, HIV was associated with a lower risk of hypertension [8]. Although prevalence of hypertension may not be increased in PLHIV, the causal factors leading to hypertension may still differ, and it is important to understand the pathogenesis in order to prevent CVD and CVD-related mortality.…”

Section: Discussionmentioning

confidence: 98%

“…Importantly, the control group was matched on age, gender, education and comorbidity index [35]. For comparison, the prevalence of hypertension was 44% among PLHIV and 58% among controls in a recent large Danish cohort study of predominantly well-treated PLHIV [8]. In that study, HIV was associated with a lower risk of hypertension [8].…”

Section: Discussionmentioning

confidence: 99%

“…Background Despite treatment with antiretroviral therapy (cART), people living with HIV (PLHIV) have lower life expectancy than HIV-uninfected individuals [1], partly explained by excess risk of cardiovascular diseases (CVD) [2][3][4][5]. Hypertension is one of the major CVD risk factors [6], but studies are contradictory as to whether prevalence of hypertension is increased in treated PLHIV compared to uninfected controls [7][8][9][10]. However, several studies showed that HIVrelated factors such as a low nadir CD4+ T-cell count and longer duration of cART were associated with increased risk of hypertension [8,9,11].…”

mentioning

confidence: 99%

“…Hypertension is one of the major CVD risk factors [6], but studies are contradictory as to whether prevalence of hypertension is increased in treated PLHIV compared to uninfected controls [7][8][9][10]. However, several studies showed that HIVrelated factors such as a low nadir CD4+ T-cell count and longer duration of cART were associated with increased risk of hypertension [8,9,11]. Mechanisms behind excess risk of CVD in PLHIV are multifactorial, and the search for underlying contributing factors is important in order to prevent morbidity and mortality.…”

mentioning

confidence: 99%

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Cytomegalovirus-specific CD8+ T-cell responses are associated with arterial blood pressure in people living with HIV

et al. 2020

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People living with HIV (PLHIV) are at increased risk for cardiovascular disease (CVD), and immunity against cytomegalovirus (CMV) may be a contributing factor. We hypothesized that enhanced T-cell responses against CMV and CMV-IgG antibody-levels are associated with higher arterial blood pressure in PLHIV. We assessed serum CMV-IgG, systolic-(SBP) and diastolic-(DBP) blood pressure, pulse pressure (PP), traditional risk factors, activated CD8+ T-cells (CD38+HLA-DR+), senescent CD8+ T-cells (CD28-CD57+) and interleukin-6 (IL-6) in 60 PLHIV and 31 HIV-uninfected controls matched on age, gender, education and comorbidity. In PLHIV, expression of interleukin-2, tumor necrosis factor-α and interferon-γ was measured by intracellular-cytokine-staining after stimulation of T-cells with CMV-pp65 and CMV-gB. Associations between CMV-specific immune responses and hypertension, SBP, DBP or PP were assessed by multivariate logistic and linear regression models adjusted for appropriate confounders. The median age of PLHIV was 47 years and 90% were male. Prevalence of hypertension in PLHIV was 37% compared to 55% of HIV-uninfected controls. CMV-specific CD8+ T-cell responses were independently associated with higher PP (CMV-pp65; β = 2.29, p = 0.001, CMV-gB; β = 2.42, p = 0.001) in PLHIV. No significant differences were found with regard to individual measures of SBP and DBP. A possible weak association was found between CMV-IgG and hypertension (β = 1.33, p = 0.049) after adjustment for age, smoking and LDL-cholesterol. HIV-related factors, IL-6, CD8+ Tcell activation or CD8+ T-cell senescence did not mediate the associations, and no associations were found between CMV-specific CD4+ T-cell responses and blood pressure in PLHIV. In conclusion, increased arterial blood pressure in PLHIV may be affected by heightened CMV-specific CD8+ T-cell responses.

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Nutrition in HIV and Tuberculosis

Baum

Tamargo

Wanke

2020

Nutrition and Infectious Diseases

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Higher Risk of Abdominal Obesity, Elevated Low-Density Lipoprotein Cholesterol, and Hypertriglyceridemia, but not of Hypertension, in People Living With Human Immunodeficiency Virus (HIV): Results From the Copenhagen Comorbidity in HIV Infection Study

Cited by 76 publications

References 37 publications

Characteristics of hypertension among people living with HIV in Ghana: Impact of new hypertension guideline

Characteristics of hypertension among people living with HIV in Ghana: Impact of new hypertension guideline

Cytomegalovirus-specific CD8+ T-cell responses are associated with arterial blood pressure in people living with HIV

Nutrition in HIV and Tuberculosis

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