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Symmetric ambulatory arterial stiffness index and 24-h pulse pressure in HIV infection: results of a nationwide cross-sectional study

Schillaci, Giuseppe and Maggi, Paolo and Madeddu, Giordano and Pucci, Giacomo and Mazzotta, Elena and Penco, Giovanni and Orofino, Giancarlo and Menzaghi, Barbara and Rusconi, Stefano and Carenzi, Laura and Celesia, Benedetto Maurizio and Martinelli, Canio and Bonfanti, Paolo and De Socio, Giuseppe Vittorio Luigi (2013) Symmetric ambulatory arterial stiffness index and 24-h pulse pressure in HIV infection: results of a nationwide cross-sectional study. Journal of Hypertension, Vol. 31 (3), p. 560-567. eISSN 1473-5598. Article.

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DOI: 10.1097/HJH.0b013e32835ca949

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Abstract

Objective: HIV infection has been associated with increased cardiovascular risk. Twenty-four-hour ambulatory blood pressure (BP) is a more accurate and prognostically relevant measure of an individual's BP load than office BP, and the ambulatory BP-derived ambulatory arterial stiffness index (AASI) and symmetric AASI (s-AASI) are established cardiovascular risk factors.
Methods: In the setting of the HIV and HYpertension (HIV-HY) study, an Italian nationwide survey on high BP in HIV infection, 100 HIV-infected patients with high-normal BP or untreated hypertension (72% men, age 48 ± 10 years, BP 142/91 ± 12/7 mmHg) and 325 HIV-negative individuals with comparable age, sex distribution, and office BP (68% men, age 48 ± 10 years, BP 141/90 ± 11/8 mmHg) underwent 24-h ambulatory BP monitoring.
Results: Despite having similar office BP, HIV-infected individuals had higher 24-h SBP (130.6 ± 14 vs. 126.4 ± 10 mmHg) and pulse pressure (49.1 ± 9 vs. 45.9 ± 7 mmHg, both P < 0.001), and a lower day-night reduction of mean arterial pressure (14.3 ± 9 vs. 16.3 ± 7%, P = 0.025). Both s-AASI and AASI were significantly higher in HIV patients (s-AASI, 0.22 ± 0.18 vs. 0.11 ± 0.15; AASI, 0.46 ± 0.22 vs. 0.29 ± 0.17; both P <0.001). In a multivariate regression, s-AASI was independently predicted by HIV infection ([beta] = 0.252, P <0.001), age, female sex, and 24-h SBP. In HIV patients, s-AASI had an inverse relation with CD4+ cell count (Spearman's [rho] ρ -0.24, P = 0.027).
Conclusion: Individuals with HIV infection and borderline or definite hypertension have higher symmetric AASI and 24-h systolic and pulse pressures than HIV-uninfected controls matched by office BP. High ambulatory BP may play a role in the HIV-related increase in cardiovascular risk.

Item Type:Article
ID Code:9012
Status:Published
Refereed:Yes
Uncontrolled Keywords:Ambulatory arterial stiffness index, ambulatory blood pressure, blood pressure monitoring, cardiovascular risk, HIV, nondippers, pulse pressure
Subjects:Area 06 - Scienze mediche > MED/17 Malattie infettive
Divisions:001 Università di Sassari > 01-a Nuovi Dipartimenti dal 2012 > Medicina Clinica e Sperimentale
Publisher:Lippincott Williams & Wilkins
eISSN:1473-5598
Deposited On:10 May 2013 10:47

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